A 21-year-old male college student had a spell of vertigo when he bumped his head against an opponent during American football drill on August 15, 1985. Severe vertigo subsided in 30 seconds but dizziness continued for several hours. On August 24, he was admitted to the Gifu University Hospital because he had an attack of vertigo when he got up in the morning. On the day of his hospitalization, spontaneous nystagmus to the right was observed. He was discharged asymptomatic on August 31. Since discharge, he had no attack of vertigo for about 1 year. On March 5, 1986, he felt rotatory vertigo lasting for about 30 seconds whenever he tackled during American football drill. On March 6, he visited our out-patient clinic. Neuro-otological examination revealed vertical rotatory nystagmus induced by head position change. CT showed a cyst in the cavum septi pellucidum and deviation of the basilar artery to the right. MRI and Metrizamide CT indicated distortion of the right vertebrobasilar artery and compression of the brainstem. Right vertebral angiography showed a tortuous vertebral artery.
It was concluded that the vertigo was due to lower brainstem disturbances caused by vertebrobasilar insufficiency. The patient was advised to discontinue American football. At present, he is free from vertigo.