The blood supply to the brain is divided into the anterior and posterior circulation. The posterior (or vertebrobasilar) circulation derives from the vertebral arteries, and supplies the brainstem, inner ear, and cerebellum. Strokes that cause vertigo usually involve the posterior circulation, and are called vertebrobasilar strokes.

About 20% of all strokes are vertebrobasilar strokes. Vertigo is the most common symptom of these strokes, and are typically accompanied by other signs of damage to the structures supplied by the same blood vessels. These may include:

  • Diplopia (Double vision)
  • Dysarthria (Slurred speech)
  • Visual field cuts
  • Cerebellar ataxia (incoordination)
  • Weakness of half the body
  • Sudden loss of hearing in one ear
  • Inability to sit up without assistance
  • Inability to walk without assistance

Only a very small number (less than 1%) of strokes manifest as vertigo alone. Even so, vertigo is one of symptoms most commonly associated with a missed diagnosis of stroke, which leads to significant morbidity and mortality.

If you experience vertigo lasting hours for the first time ever, there is a possibility that you suffered a vertebrobasilar stroke. In the presence of any of the abovementioned signs, the chances are higher and you need to seek emergent medical attention.

Remember: If you have any concern that you may be having a stroke, you need to seek emergent medical attention. Call 911.