The posterior circulation accounts for around 20% of cerebral ischemic strokes. According to estimates, 20% of these individuals appear with solitary vertigo. This symptom is incorrectly classified as peripheral vestibular in roughly one-sixth to one-third of these patients [1]. As a result, therapeutic and secondary preventive treatment is deferred from these missing stroke patients, potentially resulting in avoidable morbidity and mortality. Based on a careful evaluation of the literature, we suggest a diagnostic method for clinical differentiating of individuals with acute vestibular syndrome [2]. A stroke involving the inferior cerebellum must be recognized because it can cause cerebellar enlargement, which can lead to brain stem compression and death unless surgery is performed [1]. We report a case of 45-year-old female who had vertigo for 4-5 months and it is not associated with vomiting and posture or climate change, imbalance while walking for 6 months. She is known case of diabetes for 2 years with ongoing Antidiabetic treatment. Evaluating a central origin vertigo or dizziness is the main consequence here.