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 involvemtation. Computerized tomography should be included in the routine work-up of acute vertigo with any associated neurologic findings to aid in proper diagnosis and effect appropriate treatment.