INTRODUCTION: Elderly patients with isolated acute vertigo are commonly encountered in clinical practice, but little is known about the underlying cause of the symptoms. MATERIAL & METHODS: We prospectively studied 24 patients aged 50-75 years with the acute onset of isolated vertigo lasting > 48 h and no abnormality on neurological examination other than nystagmus. The study protocol included neuro-imaging (MRI 22 patients, CT 2 patients), Doppler sonography, and electro-oculography. RESULTS: MRI/CT showed the presence of an infarction of the caudal cerebellum in six patients (25%), 3 of whom had a potential cardioembolic source and normal Doppler sonography findings, whereas 3 patients had ipsilateral vertebral artery occlusion and normal cardiac findings. MRI of the posterior fossa was normal in 18 patients. On electro-oculography, ataxic pursuit eye movements was a characteristic finding in patients with cerebellar infarction, whereas caloric test findings were not discriminative. CONCLUSION: A caudal cerebellar infarction may easily be misdiagnosed clinically as a labyrinthine disorder, and was found to be the cause in one fourth of patients presenting with isolated acute vertigo.
INTRODUCTION: Elderly patients with isolated acute vertigo are commonly encountered in clinical practice, but little is known about the underlying cause of the symptoms. MATERIAL & METHODS: We prospectively studied 24 patients aged 50-75 years with the acute onset of isolated vertigo lasting > 48 h and no abnormality on neurological examination other than nystagmus. The study protocol included neuro-imaging (MRI 22 patients, CT 2 patients), Doppler sonography, and electro-oculography. RESULTS: MRI/CT showed the presence of an infarction of the caudal cerebellum in six patients (25%), 3 of whom had a potential cardioembolic source and normal Doppler sonography findings, whereas 3 patients had ipsilateral vertebral artery occlusion and normal cardiac findings. MRI of the posterior fossa was normal in 18 patients. On electro-oculography, ataxic pursuit eye movements was a characteristic finding in patients with cerebellar infarction, whereas caloric test findings were not discriminative. CONCLUSION: A caudal cerebellar infarction may easily be misdiagnosed clinically as a labyrinthine disorder, and was found to be the cause in one fourth of patients presenting with isolated acute vertigo.
Authors: Alexander A Tarnutzer; Aaron L Berkowitz; Karen A Robinson; Yu-Hsiang Hsieh; David E Newman-Toker Journal: CMAJ Date: 2011-05-16 Impact factor: 8.262
Authors: Babak B Navi; Hooman Kamel; Maulik P Shah; Aaron W Grossman; Christine Wong; Sharon N Poisson; William D Whetstone; S Andrew Josephson; S Claiborne Johnston; Anthony S Kim Journal: Mayo Clin Proc Date: 2012-10-12 Impact factor: 7.616