Vertigo as a compass, stroke in cerebellar territory: A case report.

Abstract

Vertigo is a common reason for medical consultation and can have serious causes, such as vertebrobasilar stroke, which accounts for 20–25% of ischemic strokes and often involves the brainstem or cerebellum, presenting with symptoms such as vertigo, ataxia, and dysmetria. Early diagnosis is essential, relying on tools such as the HINTS protocol and neuroimaging. Treatment will depend on the timing and the segment of the posterior circulation that is occluded. To highlight its importance, we present the case of a 59-year-old patient who presented with sudden-onset vertigo, headache, and cerebellar signs, with a CT angiogram showing an infarction in the territory of the PICA due to vertebral artery dissection. The patient's clinical presentation is consistent with descriptions in the literature, and although vertebral dissection usually affects younger patients, it should also be considered in older adults. The importance of the HINTS protocol as a screening tool is emphasized, recommending its incorporation into clinical practice and the need to better define criteria for reperfusion therapies in these cases.