Friday, July 02, 2010

The dizzies: ordinary vertigo or cerebellar infarction?

A recent review article is available here. Here's why this is important:

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.

1 comment:

Anonymous said...

I came into the ER with severe dizzienss and nausea and voniting. I got and MRI which was inconclusive. Then a stat .MRI was ordered which too hours to happen. In the meantime, I was given zofran, abd reglan. And anothother drug to prevent swelling on the brain. Now I feel fine just weak. I think its time to be dischaged. I am being premature?