Cerebellar arteriovenous malformation presenting with recurrent positional vertigo
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Posterior fossa arteriovenous malformations (AVMs) are rare neurovascular lesions which are incidentally diagnosed or present with headaches, seizures or neurological deficits due to intracranial haemorrhage or mass effect [1, 2, 3]. Vertigo is an uncommon primary manifestation. We describe a patient who presented with episodic positional vertigo and nystagmus attributable to a cerebellar AVM.
A 43-year-old female presented with a 15-year history of brief episodes of spinning vertigo brought on by turning over in bed. She had intermittent right-sided tinnitus and throbbing headaches unassociated with the vertigo. On initial interictal assessment, she had no spontaneous, gaze-evoked or head-shaking nystagmus, and a negative head impulse test. Very low amplitude (< 2°/s) persistent geotropic torsional nystagmus was seen on both Dix–Hallpike tests. A differential diagnosis of benign positional vertigo (BPV) or vestibular migraine was considered. Audiovestibular testing and...
This research was funded by the National Health and Medical Research Council (APP1010017).
Compliance with ethical standards
Conflicts of interest
The authors declare that they have no conflict of interest.
This case study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Informed consent was obtained from the patient.
Online Resource 1 Video-oculography during right and left Dix-Hallpike tests on the Epley Omniax rotator. (M4V 85098 KB)
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