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Isolated hemorrhage in the cerebellar vermis with vertigo and body lateropulsion to the contralesional side

  • Lee, Dong Hyun (Department of Neurology, Yeungnam University of College of Medicine) ;
  • Lee, Se-Jin (Department of Neurology, Yeungnam University of College of Medicine)
  • Received : 2019.06.22
  • Accepted : 2019.08.28
  • Published : 2019.09.30

Abstract

There have been several reports of patients with isolated lesions of the cerebellar vermis presenting with clinical features similar to those of peripheral vestibulopathy. We report a case of small, isolated hematoma in the cerebellar vermis in a patient who presented with vertigo, ipsilesional nystagmus, and body lateropulsion to the contralesional side without the usual signs or symptoms of cerebellar dysfunction. Although they present with symptoms that mimic those of peripheral vestibulopathy, and brain computed tomography shows no abnormality, as there may be a small, isolated hematoma or infarction in the cerebellar vermis. Thus, brain magnetic resonance imaging should be performed in elderly patients with vascular risk factors.

Keywords

References

  1. Kase CS, Mohr JP, Caplan LR. Intracerebral hemorrhage. In: Mohr JP, Choi DW, Grotta JC, Weir B, Wolf PA, editors. Stroke: pathophysiology, diagnosis, and management. 4th ed. Philadelphia: Churchill Livingstone; 2004. p. 327-76.
  2. Kattah JC, Kolsky MP, Luessenhop AJ. Positional vertigo and the cerebellar vermis. Neurology 1984;34:527-9. https://doi.org/10.1212/WNL.34.4.527
  3. Huang CY, Yu YL. Small cerebellar strokes may mimic labyrinthine lesions. J Neurol Neurosurg Psychiatry 1985;48:263-5. https://doi.org/10.1136/jnnp.48.3.263
  4. Johkura K. Central paroxysmal positional vertigo: isolated dizziness caused by small cerebellar hemorrhage. Stroke 2007;38:e26-7. https://doi.org/10.1161/STROKEAHA.106.480319
  5. Lee H, Yi HA, Cho YW, Sohn CH, Whitman GT, Ying S, et al. Nodulus infarction mimicking acute peripheral vestibulopathy. Neurology 2003;60:1700-2. https://doi.org/10.1212/01.WNL.0000063325.77498.20
  6. Lee H, Cho YW. A case of isolated nodulus infarction presenting as a vestibular neuritis. J Neurol Sci 2004;221:117-9. https://doi.org/10.1016/j.jns.2004.03.022
  7. Lee H. Isolated body lateropulsion caused by a lesion of the rostral vermis. J Neurol Sci 2006;249:172-4. https://doi.org/10.1016/j.jns.2006.06.014
  8. Oh YM, Choi KD, Oh SY, Kim JS. Periodic alternating nystagmus with circumscribed nodular lesion. Neurology 2006;67:399. https://doi.org/10.1212/01.wnl.0000219818.35451.10
  9. Muley SA, Bushara KO. Isolated gait ataxia due to cerebellar vermis infarct. Arch Neurol 2004;61:1461. https://doi.org/10.1001/archneur.61.9.1461
  10. Shan DE, Wang V, Chen JT. Isolated lateropulsion of the trunk in cerebellar infarct. Clin Neurol Neurosurg 1995;97:195-8. https://doi.org/10.1016/0303-8467(95)00026-G
  11. Bertholon P, Michel D, Convers P, Antoine JC, Barral FG. Isolated body lateropulsion caused by a lesion of the cerebellar peduncles. J Neurol Neurosurg Psychiatry 1996;60:356-7. https://doi.org/10.1136/jnnp.60.3.356
  12. Lee H, Sohn CH. Axial lateropulsion as a sole manifestation of lateral medullary infarction: a clinical variant related to rostral-dorsolateral lesion. Neurol Res 2002;24:773-4. https://doi.org/10.1179/016164102101200870
  13. Kim SH, Cho J, Cho JH, Han SW, Kim SM, Park SC, et al. Isolated lateropulsion by a lesion of the dorsal spinocerebellar tract. Cerebrovasc Dis 2004;18:344-5. https://doi.org/10.1159/000080978
  14. Thomke F, Marx JJ, Iannetti GD, Cruccu G, Fitzek S, Urban PP, et al. A topodiagnostic investigation on body lateropulsion in medullary infarcts. Neurology 2005;64:716-8. https://doi.org/10.1212/01.WNL.0000152040.27264.1A
  15. Norrving B, Magnusson M, Holtas S. Isolated acute vertigo in the elderly; vestibular or vascular disease? Acta Neurol Scand 1995;91:43-8. https://doi.org/10.1111/j.1600-0404.1995.tb05841.x