Acute cerebellar vertigo in a fighter pilot

Vertigo is a frequently encountered complaint among aviators. This complaint is usually labyrinthine in origin. We present a case of a combat jet fighter pilot who experienced a vertiginous episode during flight that nearly resulted in a mishap. Work-up revealed a dissecting aneurysm of the posterior inferior cerebellar artery. Coiling of the aneurysm was performed. This case emphasizes the importance of performing a complete vestibular evaluation in aviators with acute vertigo. Since central nervous system causes may be responsible for vertiginous events, and when undiagnosed may result in a recurrence during flight, magnetic resonance scanning should be considered in those with no obvious peripheral cause for their vertigo.