Abstract

Acute vestibular syndrome is often due to vestibular neuritis but can result from vertebrobasilar strokes. Misdiagnosis of posterior fossa infarcts in emergency care settings is frequent. As many as 25% of patients with risk factors for stroke who present to an emergency medical setting with isolated, severe vertigo, nystagmus, and postural instability have an infarction of the brainstem or cerebellum. Bedside oculomotor findings may reliably identify stroke in acute vestibular syndrome. The presence of normal horizontal head impulse test, direction-changing nystagmus in eccentric gaze, or skew deviation (vertical ocular misalignment) was very sensitive for diagnosis of stroke. This article was included about the clinical symptoms and neurological examinations of vascular vertigo, especially focusing on differential diagnosis of ischemic stroke of the vertebrobasilar territory from the acute peripheral vestibular syndrome, and therapeutic aspect for vascular vertigo.