Central Paroxysmal Positional Vertigo: Isolated Dizziness Caused by Small Cerebellar Hemorrhage

To the Editor:Kerber et al1 report that the proportion of cerebrovascular events in patients presenting to the emergency department with dizziness, vertigo, or imbalance is very low (3.2%), and when these symptoms are not accompanied by any other neurological signs or symptoms, stroke/transient ischemic attack is diagnosed in only 0.7% of patients. They conclude that dizziness, vertigo, and/or imbalance in isolation is a strong indicator of a noncerebrovascular cause. We agree with their conclusion. However, there is a potentially serious pitfall.We reported the diagnoses in consecutive patients presenting to the emergency department of our hospital between April 2002 and …