Vertigo caused by brain lesions is called central vertigo, and the lesions are mostly located in the brainstem and cerebellum. The common causes are cerebrovascular lesions, intracranial tumors, cranial inflammation, such as insufficient blood supply to the vertebrobasilar artery, thrombosis of the posterior inferior cerebellar artery, brainstem tumors, brainstem encephalitis, medullary cavitation, multiple sclerosis, cerebellar tumors, etc. These lesions can produce vertigo if they involve the vestibular nucleus or its connecting pathways, and the vertigo symptoms last for a long time. Central vertigo attacks may be accompanied by symptoms such as partial body movement disorder, numbness, slurred speech, double vision, etc. Nystagmus may appear, and the amplitude of nystagmus is large, vertical or rotational, with long duration, different degrees, variable directions, or even bidirectional. In addition, patients can also appear vestibular decompensation phenomenon, that is, weak stimuli cause strong response, strong stimuli cause a weak response instead. By variable temperature test, it can be found that the hot and cold responses are separated, with a predominance of bias to the affected side. The treatment of central vertigo is divided into symptomatic and allopathic treatment. Symptomatic treatment is to relieve the feeling of vertigo and nausea and vomiting by taking sedative-hypnotics (phenobarbital, diazepam), antihistamines (diphenhydramine hydrochloride, promethazine hydrochloride), and anticholinergics (scopolamine, atropine). In addition to symptomatic treatment, treatment should be combined with the cause. Central vertigo is commonly found in patients with brain tumors and cerebrovascular diseases, and brain tumors can be treated by surgical removal and radiotherapy; vascular diseases rely mainly on corresponding medication, and the specific treatment plan is determined by the doctor according to the relevant examination results.