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- Any patient presenting with an acute onset of dizziness described as a spinning sensation should be thoroughly assessed for cerebellar stroke, as these often present in such a manner, prior to assuming that the source is simple vertigo.
- Cerebellar strokes, whether due to infarct or hemorrhage, typically present with ataxic gait, abnormal Rhomberg, dysmetria with finger-to-nose and heel-to-shin testing, and nystagmus.
- In addition, the dizziness associated with cerebellar strokes should be less reproducible and extinguishable than that due to simple vertigo.
- In terms of imaging, remember that CT scanning is not the preferred radiologic modality for evaluating the cerebellum and posterior aspects of the brain; the thickness of the posterior skull tends to create significant artifact and distortion. If suspicion warrants, MRI should therefore be pursued.