Recurrent Positional Vomiting due to Cerebellar Infarction and Obstructive Hydrocephalus

Area of Science:

• Neurology
• Neuroscience
• Medical Case Study

Background:

• Cerebellar infarction is a stroke affecting the cerebellum, a brain region crucial for coordination and balance.
• Sudden onset vertigo and vomiting are common symptoms of acute cerebellar infarction.
• Recurrent vomiting in patients with cerebellar infarction can be challenging to manage.

Purpose of the Study:

• To describe a case of recurrent positional vomiting in a patient with acute cerebellar infarction.
• To investigate the potential link between intracranial pressure fluctuations, hydrocephalus, and postural triggers in this patient.
• To emphasize the diagnostic importance of considering postural triggers in similar cases.

Main Methods:

• Case report of an 80-year-old woman diagnosed with acute cerebellar infarction.
• Clinical observation of vomiting episodes triggered by postural changes.
• Brain computed tomography (CT) to assess for edema, ventricular enlargement, and fourth ventricular outlet compression.

Main Results:

• The patient experienced 23 episodes of positional vomiting over 1 month, primarily when lying down.
• Brain CT revealed cerebellar edema, compression of the fourth ventricular outlet, and lateral ventricular enlargement.
• Findings suggest intermittent obstructive hydrocephalus linked to intracranial pressure fluctuations and posture.

Conclusions:

• Positional vomiting in acute cerebellar infarction may be caused by intermittent obstructive hydrocephalus exacerbated by posture.
• Clinicians should consider postural triggers when evaluating recurrent vomiting in patients with cerebellar infarction.
• This case underscores the complex interplay between cerebellar lesions, intracranial pressure dynamics, and symptomatology.