Vertebral artery dissection presenting as isolated vertigo

Area of Science:

• Neurology
• Vascular Neurology
• Emergency Medicine

Background:

• Vertigo is a common emergency department complaint, often stemming from peripheral vestibular issues.
• Central causes of vertigo, though less common, can indicate serious neurological conditions like stroke.
• Distinguishing central from peripheral vertigo is critical for appropriate patient management.

Observation:

• This report details a case of isolated vertigo due to a brainstem infarct.
• The infarct was specifically caused by vertebral artery dissection (VAD).
• Vertebral artery dissection is an increasingly recognized cause of stroke in younger populations.

Findings:

• Brainstem infarct secondary to vertebral artery dissection can manifest as isolated vertigo.
• Specific clinical features can help differentiate central vertigo from peripheral causes.
• Vertebral artery dissection represents a significant, potentially treatable, cause of central vertigo.

Implications:

• Recognition of VAD as a cause of central vertigo is vital for emergency physicians.
• Early diagnosis and management of VAD can prevent further ischemic events.
• This case highlights the importance of considering central etiologies in vertigo presentations.