[Three cases of small brain infarction in the lateral wall of the fourth ventricle presenting with paroxysmal positional vertigo and vomiting]

Masashi Hosomi, Keiji Matsumoto, Yasufumi Kageyama, Keiji Ichikawa
Rinshō Shinkeigaku, Clinical Neurology 2008, 48 (10): 709-12
A lesion responsible for central paroxysmal positional vertigo (PPV) is often found in the dorsolateral wall of the fourth ventricle. A relatively large tumor or hemorrhage in the dorsolateral wall of the fourth ventricle usually causes central PPV, but small brain infarction has hardly been reported to cause central PPV. We report three cases of a small brain infarction in the lateral wall of the fourth ventricle presenting with central PPV. All of the cases showed similar clinical features in which a given recumbent position and a sitting position caused a dizziness associated with nausea and vomiting over an acute period. The symptom lasted one to two months after the onset. In two of our cases, no neurological abnormal signs, except nystagmus, were observed, and initial differentiation of central PPV from peripheral PPV was difficult. Interruption of the vestibular nuclei-archicerebellar loop seems to be responsible for the central PPV. Recognition of the clinical features of central PPV and diffusion-weighted MRI images are important for a precise local diagnosis in small brain infarction showing PPV.


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"