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Cerebellar infarction — ABEM Board MCQ

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HardNeurological emergenciesCerebellar infarctionABEM Board

A 63-year-old man presents as triage level 2 with sudden vertigo, vomiting, inability to walk, and occipital headache. HINTS exam by a trained clinician shows direction-changing nystagmus and skew deviation. CT head is negative. Which of the following is the most likely diagnosis?

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Correct answer: A — Cerebellar stroke

Central HINTS findings and severe truncal ataxia are concerning for posterior circulation stroke despite a negative early CT.

Reference: AHA/ASA stroke guidance; ABEM EM Model