Is vomiting a symptom of stroke
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Summary
10 papers analyzed
These studies suggest that vomiting can be a symptom of stroke, particularly in ischemic brainstem strokes and as an early predictor of severe outcomes.
Consensus Meter
6 papers analyzed
Yes - 83%
Possibly - 17%
No - 0%
Research summarized with Copilot
Beta20 papers analyzed
Vomiting as a Symptom of Stroke
Prevalence of Vomiting in Stroke Patients
Vomiting is a relatively common symptom among stroke patients, though its prevalence varies depending on the type of stroke. In a study involving 1968 confirmed stroke patients, vomiting was observed in 14.5% of all cases. When broken down by stroke type, vomiting occurred in 8.7% of cerebral infarction (CI) cases, 23.7% of cerebral hemorrhage (CH) cases, and 36.8% of subarachnoid hemorrhage (SAH) cases.
Vomiting and Stroke Outcomes
The presence of vomiting at the onset of a stroke is associated with a higher risk of mortality. Patients who experienced vomiting had a significantly higher hazard ratio (HR) for death compared to those who did not. This was true across all types of strokes, with HRs of 5.27 for CI, 2.82 for CH, and 5.07 for SAH, indicating a strong correlation between vomiting and poor outcomes.
Diagnostic Challenges
Vomiting can sometimes be a prominent symptom in ischemic strokes involving the lower brainstem, even when other neurological symptoms are minimal or absent. This can lead to misdiagnosis as a gastrointestinal disorder, complicating the timely and accurate diagnosis of stroke. Additionally, vomiting is one of the symptoms that can lead to false negatives in emergency medical services (EMS) assessments, making it challenging to identify stroke patients accurately.
Unique Symptoms in Women
Research indicates that women may experience unique stroke symptoms, including nausea and vomiting, more frequently than men. This can contribute to delays in recognition and treatment, as current stroke assessment tools are not always sensitive to these unique symptoms.
Vomiting and Brain Swelling
Vomiting within 24 hours of stroke onset is also an independent predictor of fatal brain swelling. Patients with high baseline National Institutes of Health Stroke Scale (NIHSS) scores and vomiting are at a significantly higher risk of developing fatal brain edema.
Case Studies and Specific Conditions
In some cases, vomiting can be a part of more complex conditions following a stroke. For instance, cyclic vomiting syndrome has been reported in a patient following a left cerebral infarct, highlighting the diverse manifestations of vomiting in stroke patients.
Conclusion
Vomiting is a significant symptom in stroke patients, associated with higher mortality rates and diagnostic challenges. Its prevalence varies by stroke type, and it can complicate the diagnosis and management of stroke, particularly in women and in cases involving the lower brainstem. Recognizing vomiting as a potential indicator of stroke can improve early diagnosis and treatment, potentially reducing the risk of fatal outcomes.
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