Posterior Circulation Stroke Misdiagnosed as Benign Paroxysmal Positional Vertigo: A Case Report.
Megan Walsh
✦ AI-curated · Sources linked
Case in brief
A 76-year-old male with vascular risk factors presented to an emergency department with sudden-onset dizziness described as 'the room is spinning.' Initially diagnosed with benign paroxysmal positional vertigo, he was later found to have severe lateropulsion, left hemiparesis, and unilateral hearing loss. Imaging confirmed a right posterior thalamic infarct, diagnosed after the reperfusion window had closed.
Diagnostic / clinical pearl
Dizziness in older patients can indicate serious conditions like posterior circulation stroke; reliance on symptom descriptors alone can lead to misdiagnosis.
Why it matters
This case highlights the importance of recognizing red flags such as hemiparesis and hearing loss in patients presenting with dizziness to avoid diagnostic delays.