Central Causes Vertigo
Table 1 – Common central causes of vertigo
| Stroke (including brainstem and midline cerebellar cerebrovascular events) |
| Vertebrobasilar or brainstem ischaemia |
| Vertebral artery dissection |
| Migraine (Migrainous vertigo) |
| Space occupying intracranial lesions |
| Focal seizure (temporal or parietal lobe) |
| Multiple sclerosis or demyelinating disorder |
| Chiari malformation |
| Episodic ataxia type two |
Central vertigo arises due to defects of the vestibular nucleus or higher central nervous system connections.
Brainstem vestibular nuclei, the cerebellum and their connections may be affected by a number of pathological processes including:
- Haemorrhage
- Infarction
- Ischaemia
- Demyelination
- Tumour compression
Central causes of vertigo are often associated with other features of brainstem or cranial nerve dysfunction. There may be a new onset headache, and patients with cerebrovascular causes of vertigo may have pre-existing cardiovascular disease or risk factors.
The mechanism by which migraine causes vertigo is not well understood, but it can be associated with migraine headache in susceptible individuals.