With vertigo patients, it is important that we pay attention to vertigo caused by central lesions as there are different diagnoses. Vertigo caused by central lesions such as brain tumors and cerebellar infarction sometimes appear as if the lesions were peripheral ones. The patient in the present study was a 50 y.o. female, with cerebellar metastasis caused by breast cancer and whose chief complaint was positional vertigo at a glance. However, detailed interview, past history, and careful neuro-otological findings based on nystagmus and the results of electric nystagmography led us to diagnose vertigo caused by a central lesion. Subsequent MRI findings revealed a cerebello-pontine angle lesion as a metastatic tumor. The ratio of brain tumors, especially metastatic tumors, among vertigo patients is low. However, this case indicated that MRI might be useful for patients who have a past history of cancer.
