Acute brain stem vertigo without neurological deficits

Abstract

An infarct at the brain stem or cerebellum is rarely associated with vertigo without any other localizing clinical features. Stroke at the posterior circulation of the brain may cause spontaneous vertigo and imbalance. In some cases, isolated posterior inferior cerebellar artery infraction presents isolated vertigo and nystagmus. The diagnosis of the brain stem vertigo can be done easily when associated with other neurological symptoms along with vertigo, whereas, when the vertigo occurs in isolation, it may be difficult to differentiate it from the other benign disorders affecting the inner ear. A head impulse test may differentiate the acute isolated vertigo with cerebellar stroke from more benign disorders associated with labyrinth. Appropriate evaluation of the patient is better than imaging for diagnosis of the brain stem vertigo. Here, we are presenting a case of isolated acute onset of the vertigo due to brain stem infarct which mimics to the peripheral vestibular pathology.

Keywords

• brain stem
• head impulse test
• isolated vertigo
• vertebrobasilar insufficiency