Cerebellar infarction - a presentation of vertigo

The differential diagnosis of acute vertigo includes cerebellar infarction. In the past, a mortality rate of 50% – 80% was reported with cerebellar infarction. This is no doubt related to an inability to accurately diagnose small lesions which carry a better prognosis. The advent of computerized tomography (CT) now permits accurate diagnosis of small cerebellar infarctions. Seven patients admitted with acute onset of vertigo which mimicked a peripheral labyrinthine disorder are presented. In all patients a cerebellar etiology was demonstrated by CT. One patient had been subjected to therapeutic labyrinthectomy; three of seven patients had associated unilateral hearing loss suggesting partial brain stem involvement. The CT findings in cerebellar infarction are often subtle and require careful interpretation. Computerized tomography should be included in the routine work‐up of acute vertigo with any associated neurologic finding to aid in proper diagnosis and effect appropriate treatment.