孤立性眩晕多由前庭周围性病变所致，而后循环缺血所致的眩晕通常伴随其他局灶性症状和体征。然而，随着神经耳科学和神经影像学的发展，越来越多的小脑和脑干梗死所致的孤立性中枢性眩晕得到诊断。约11%的孤立性小脑梗死患者表现为孤立性眩晕、眼球震颤和姿势不稳。头脉冲试验（head impulse test，HIT）阳性可以将其小脑卒中相关的急性孤立性眩晕与累及内耳的良性疾病区分开来。急性前庭听力丧失可能预示小脑前下动脉区域即将发生梗死。三步床边眼动检查法[ 头脉冲- 眼震- 扭转偏斜试验（head impulse，nystagmus，test of skew，HINTS）] 优于磁共振成像。本文就脑干和小脑后循环卒中并发急性孤立性眩晕综合征的诊断要点进行综述。

Isolated vertigo is usually caused by perivestibular lesions. Vertigo caused by posterior circulation ischemia is usually accompanied by other local symptoms and signs. However, with the development of neurootology and neuroimaging, more and more isolated central vertigoes caused by cerebellar and brainstem infarction have been diagnosed. About 11% of the patients with isolated cerebellar infarction present with isolated vertigo, nystagmus and postural instability. Positive results of head impulse test (HIT) can distinguish acute isolated vertigo related to cerebellar stroke from benign diseases involving inner ear. Acute vestibular hearing loss may indicate the infarct in the anterior inferior cerebellar artery region. Bedside examinations including head impulse test, nystagmus and test of skew (HINTS) are superior to magnetic resonance imaging. In this paper, the diagnosis of acute isolated vertigo syndrome complicated by brainstem and posterior cerebellar circulation stroke is reviewed.