The advent of magnetic resonance imaging and angiography has clarified
the location and vascular basis for vertigo of a syndromal type. The
composite presentation of a vestibular symptom with evidence of crania
l nerve or cerebellar dysfunction suggests a lesion within the pens, m
edulla, or cerebellum. The location may be exactly defined by noninvas
ive techniques and appropriate therapy can be initiated Clinical examp
les are presented; the syndromes of vertebrobasilar artery perfusion d
isorder are described, and appropriate images are illustrated for conf
irmation.