Abstract
A 21-year-old man consulted our clinic complaining of acute vertigo and nausea. He showed sponta-neous upbeat nystagmus, but there were no other significant neurological findings. As visual suppression (VS) of the manually rotated vestibulo-ocular reflex (VOR) was severely impaired, MRI and MRA examination were immediately ordered. MRA showed stenosis of the left vertebral artery and Ti-weighted MRI demonstrated intramural hematoma in the stenotic region. Further examination with digital subtraction angiography demonstrated stenosis of the left vertebral artery, which was compatible with arterial dissection. Arterial dissection must be considered as a cause of possible central vertigo. VS of the VOR was useful for detecting disorder of the central vestibular system in this case.
