False-negative diffusion-weighted MRI in acute cerebellar stroke

Physicians who examine patients with acute severe isolated vertigo or dizziness should consider the possibility of false-negative DW MRI findings in case of hyperacute ischemic stroke. It is important to observe the nystagmus periodically after onset. The MR examination should be repeated more than 24 h after symptom onset in patients with an atypical pattern of nystagmus for benign peripheral vestibular disorders.