<![CDATA[Vertigo is a common complaint in emergency departments and neurology clinics. Although most cases are caused by peripheral vestibular disorders, a minority result from central nervous system lesions that may be life threatening and difficult to distinguish based solely on clinical symptoms. Case Presentation: A 51 year old woman presented with persistent rotatory vertigo for two months, worsening over the previous three days, accompanied by recurrent vomiting, intermittent hand tremor, and headache. Examination revealed horizontal left beating nystagmus and a Romberg test with consistent falling to the left, without focal motor, sensory, or cranial nerve deficits. Non contrast cranial CT demonstrated a poorly defined, heterogeneously hyperdense lesion in the left cerebellar hemisphere with surrounding hypodense perifocal edema and no midline shift, suggestive of an intracranial mass. Clinical improvement was observed after four days of antiemetics, corticosteroids, and vestibular suppressants, followed by referral for neurosurgical and oncological evaluation. Conclusion: Persistent vertigo without focal neurological deficits may be an early sign of a cerebellar lesion. Recognition of red flags and timely neuroimaging are essential to avoid delayed diagnosis of potentially life threatening intracranial pathology.]]>
Copyrights © 2026
