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HNO

, Volume 65, Supplement 2, pp 149–152 | Cite as

Acute vestibular syndrome in cerebellar stroke

A case report and review of the literature
  • V. VolggerEmail author
  • R. Gürkov
Case report

Abstract

The current paper reports on a patient with recurrent rotational vertigo and persistent dizziness and imbalance lasting several weeks, who underwent extensive neuro-otological and radiological examinations. Pathological findings initially included right-sided benign paroxysmal positional vertigo (BPPV), persistent horizontal spontaneous nystagmus (SPN) to the left, and a pathological bedside and video head impulse test (HIT) on the left. The pathological HIT on the left and the SPN to the left indicated a central origin. Therefore, cranial magnetic resonance imaging was performed which revealed a left-sided ischemic stroke in the territory of the medial branch of the posterior inferior cerebellar artery (mPICA).

Keywords

Cerebellar stroke Cerebellar disease Benign paroxysmal positional vertigo Pathologic nystagmus Magnetic resonance imaging 

Akutes vestibuläres Syndrom nach Kleinhirninfarkt

Fallbericht und Literaturrecherche

Notes

Compliance with ethical guidelines

Conflict of interest

V. Volgger and R. Gürkov declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors. Consent was obtained from all patients identifiable from images or other information within the manuscript. In the case of underage patients, consent was obtained from a parent or legal guardian.

The supplement containing this article is not sponsored by industry.

Literatur

  1. 1.
    Lee H, Sohn SI, Cho YW, Lee SR, Ahn BH, Park BR, Baloh RW (2006) Cerebellar infarction presenting isolated vertigo. Frequency and vascular topographical patterns. Neurology 67:1178–1183CrossRefPubMedGoogle Scholar
  2. 2.
    Nelson JA, Viirre E (2009) The clinical differentiation of cerebellar infarction from common vertigo syndromes. West J Emerg Med 10(4):273–277PubMedPubMedCentralGoogle Scholar
  3. 3.
    Newman-Toker DE, Kattah JC, Alvernia JE, Wang DZ (2008) Normal head impulse test differentiates acute cerebellar strokes from vestibular neuritis. Neurology 70:2378–2385CrossRefPubMedGoogle Scholar
  4. 4.
    Voogd JAN, Gerrts NM, Ruigrok TH (1996) Organization of the vestibulocerebellum. Ann NY Acad Sci 781:553–579CrossRefPubMedGoogle Scholar
  5. 5.
    Fushiki H, Barmack NH (1997) Topography and reciprocal activity of cerebellar Purkinje cells in the uvula-nodulus modulated by vestibular stimulation. J Neurophysiol 78:3083–3094PubMedGoogle Scholar
  6. 6.
    Ogawa K, Suzuki Y, Oishi M, Kamei S, Shigihara S, Nomura Y (2013) Clinical study of medial area infarction in the region of posterior inferior cerebellar artery. J Stroke Cerebrovasc Dis 22(4):508–513CrossRefPubMedGoogle Scholar
  7. 7.
    Kattah JC, Talkad AV, Wang DZ et al (2009) HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging. Stroke 40:3504–3510CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Huh YE, Kim JS (2011) Patterns of spontaneous and head-shaking nystagmus in cerebellar infarction: imaging correlations. Brain 134:3662–3671CrossRefPubMedGoogle Scholar
  9. 9.
    Chen L, Todd M, Halmagyi GM, Aw S (2014) Head impulse gain and saccade analysis in pontine-cerebellar stroke and vestibular neuritis. Neurology 83:1513–1522CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Lee H (2009) Neuro-otological aspects of cerebellar stroke syndrome. J Clin Neurol 5(2):65–73CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Chen L, Lee W, Chambers BR, Dewey HM (2011) Diagnostic accuracy of acute vestibular syndrome at the bedside in a stroke unit. J Neurol 258:855–861CrossRefPubMedGoogle Scholar
  12. 12.
    Shoman N, Longridge N (2007) Cerebellar vermis lesions and tumours of the fourth ventricle in patients with positional and positioning vertigo and nystagmus. J Laryngol Otol 121(2):166–169CrossRefPubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH 2017

Authors and Affiliations

  1. 1.Klinikum der Universität MünchenLudwig-Maximilians-UniversitätMünchenGermany

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