Medullary hemorrhage causing vertigo and gaze nystagmus

Brainstem hematomas carry a poor prognosis. There are rare reports of excellent outcome with hemorrhages in the midbrain. We report a 43-year-old woman with vertigo and minimal neurological symptoms, whose symptoms were initially mistaken for "inner ear disease," but subsequent investigations revealed a medullary hemorrhage. Recovery was complete within two weeks. While rare, medullary hemorrhage should be considered in the differential diagnosis of vertigo.