Dental procedure induced cerebellar haemorrhage with visual tilt and unsuspected CADASIL

A man in his late 60s had vertigo and vision tilt following a dental procedure. A cerebellar haemorrhage and cerebral microbleeds (CMBs) were diagnosed on imaging. Subsequent testing revealed CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy). The role of the dental procedure as a trigger for intracerebral haemorrhage (ICH) is discussed. The incidence of CMBs and ICH in CADASIL is discussed. A summary of the causes and pathology associated with visual tilt is documented.