[Acute vertigo caused by cerebellar vascular accident].

At the beginning, small cerebellar strokes may present only with acute onset of vertigo, unsteadiness and unidirectional nystagmus, like a vestibular neuritis. In some cases, it is associated with tinnitus and hearing disturbance, like an endolymphatic hydrops. Other cases may mimic a benign cupulolithiasis, with only a paroxysmal positioning vertigo. Attention should be focused on transient associated symptoms: headache and blurred vision. One should not wait for classical cerebellar clinical signs: they are subtle and they appear late. Within a few days, the clinical picture will change: vertigo will disappear, while unsteadiness will progress. The electronystagmography confirms the integrity of the vestibular peripheric system. The cerebral CT Scan will show the ischaemic lesions only several days after the onset of the symptoms. A magnetic resonance imaging is far more efficient. Small cerebellar strokes have a good prognosis: complete recovery may be hoped with acetylsalicylic acid treatment and kinesitherapy.