While most patients who present to emergency departments (ED) with isolated vertigo have benign disorders, approximately 0.7–3% have cerebellar infarction.1,2Because the symptoms of cerebellar infarction overlap substantially with benign conditions it is commonly overlooked, with a misdiagnosis rate estimated at 35%2. Patients with missed cerebellar infarction in general are at higher risk for complications, with a mortality rate possibly as high as 40%.3
Physical diagnosis is the most important diagnostic modality for cerebellar infarction. Resorting to computed tomography (CT) is insufficient because it is only 26% sensitive for acute stroke.4 In contrast, important physical signs are present in the majority of patients with cerebellar infarction.
Friday, July 02, 2010
The dizzies: ordinary vertigo or cerebellar infarction?
A recent review article is available here. Here's why this is important: