Signs of stroke vomiting
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Signs of Stroke: Vomiting as a Key Indicator
Vomiting as a Predictor of Stroke Outcome
Vomiting is a significant symptom in stroke patients and can be an early predictor of stroke outcomes. Research indicates that vomiting occurs in approximately 14.5% of all stroke patients, with varying prevalence across different types of strokes: 8.7% in cerebral infarction (CI), 23.7% in cerebral hemorrhage (CH), and 36.8% in subarachnoid hemorrhage (SAH). The presence of vomiting at the onset of a stroke is associated with a significantly higher risk of mortality compared to patients without vomiting.
Vomiting in Ischemic Brainstem Strokes
In cases of ischemic brainstem strokes, vomiting can be a prominent symptom even when other neurological abnormalities are minimal or absent. This can lead to misdiagnosis as a gastrointestinal disorder rather than a stroke. It is crucial for healthcare providers to recognize this pattern to avoid diagnostic errors.
Cyclic Vomiting Syndrome Post-Stroke
There are rare instances where patients develop cyclic vomiting syndrome (CVS) after a stroke. CVS is characterized by recurrent episodes of vomiting separated by symptom-free periods. This condition can be managed effectively with appropriate treatment, such as imipramine hydrochloride, as demonstrated in a case study of a 69-year-old woman who developed CVS following a left cerebral infarct.
Vomiting in Hemorrhagic Stroke
Hemorrhagic strokes often present with vomiting, alongside other symptoms such as headache and altered consciousness. Vomiting is observed in 58% of hemorrhagic stroke cases, making it a common symptom that necessitates immediate medical attention . The intensity and frequency of vomiting can help differentiate between types of hemorrhagic strokes, such as intracerebral hemorrhage and subarachnoid hemorrhage.
Diagnostic Challenges in Emergency Settings
Identifying stroke in emergency settings can be challenging, especially when patients do not present with typical symptoms like facial weakness or speech disturbances. Vomiting, along with other symptoms such as dizziness and changes in mental status, is frequently documented in cases where strokes are not initially identified by emergency medical services (EMS). This highlights the need for comprehensive stroke screening tools that include a broader range of symptoms.
Vomiting and Fatal Brain Swelling
Vomiting within the first 24 hours of stroke onset is a significant predictor of fatal brain swelling in patients with massive hemispheric ischemic strokes. This symptom, along with other factors such as high systolic blood pressure and extensive hypodensity on CT scans, can help identify patients at high risk for developing fatal brain edema .
Conclusion
Vomiting is a critical symptom in stroke patients that can indicate the severity and type of stroke, as well as predict outcomes. Recognizing vomiting as a potential sign of stroke, especially in the absence of other typical symptoms, is essential for timely and accurate diagnosis. This can lead to better management and improved survival rates for stroke patients.
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