Cerebellum Tumor Presenting Itself With Positional Vertigo and Benign Paroxysmal Positional Vertigo

Abstract

The purpose of this case is to describe the positional vertigo observed in a patient diagnosed with cerebellar arteriovenous malformation, pay attention to the importance of medical history taking and physical examination in vertigo patients. A 51-year-old patient went to the Ear, Nose, and Throat clinic with a complaint of vertigo. His vertigo was like peripheral vertigo at the beginning. Dizziness was triggered by head movements. He experienced tinnitus in the left ear during vertigo attacks. The patient also had neck pain. In physical examination, natural bilateral tympanic membrane and facial examination were observed. Other physical examinations were normal. In the positional vertigo tests, the right Dix-Hall Pike test was positive and a downbeating geotropic nystagmus was found. The patient was treated with canalith repositioning maneuver (Epley maneuver). Oral medical treatment started and after 4 days, the patient reported that his gait balance was disturbed and his neck pain continued. After that magnetic resonance imaging was requested. Magnetic resonance imaging was consistent with cerebellar arteriovenous malformation. The patient was consulted to the neurology service. Cerebellar arteriovenous malformation had features like to peripheral vertigo, and the correct diagnosis is made due to suspected headache and other neurological symptoms.