Objective: To determine the incidence of stroke among patients with acute vestiular syndrome [AVS] and find factors that can predict stroke.

Materials and Methods: A prospective, observational study was conducted between March 1 and November 30, 2016. Patients with AVS underwent constructive history taking and physical examination. Final diagnoses were made by imaging or clinical follow-up with specialists.

Results: The present study enrolled 394 patients (73% age ≥50; 68% female). The incidence of stroke was 3% (12/394). The predicting factors for cerebellar stroke were identified as male gender (OR 6.79, 95% CI 1.81 to 25.55), systolic blood pressure (OR 1.03, 95% CI 1.01 to 1.06), diastolic blood pressure (OR 1.06, 95% CI 1.01 to 1.1), medical history of stroke/transient ischemic attack (OR 6.37, 95% CI 1.59 to 25.46), duration of symptoms greater than 24 hours (OR 6.66, 95% CI 2.91 to 22.04), symptoms of imbalance (OR 5.96, 95% CI 1.76 to 20.23), disproportionate symptoms (OR 11.32, 95% CI 3.45 to 37.21), GCS of less than 15 at presentation (OR 76.2, 95% CI 6.37 to 911.03), deficit CN examination (OR 76, 95% CI 6.36 to 908.64), positive tandem gait (OR 25.13, 95% CI 6.97 to 90.62), positive truncal ataxia (OR 33.27, 95% CI 9.24 to 119.75), and positive finger-to-nose test (OR 63, 95% CI 9.35 to 424.34).

Conclusion: Only 3% of AVS in the emergency department [ED] was due to cerebellar stroke. The small number of outcomes precluded a multivariate analysis, but several clinical factors were identified.

Keywords: Acute vestibular syndrome, Cerebellar stroke, Posterior circulation stroke, Emergency department