Stroke vomiting

Pro Research Analysisby

Searched over 200M research papers for "stroke vomiting"

Analyzed relevant papers

The Role of Vomiting in Stroke: Predictive Value and Clinical Implications

Vomiting as a Predictor of Stroke Outcome

Vomiting is a common symptom in stroke patients and has significant implications for predicting stroke outcomes. A study examining 1,968 stroke patients found that vomiting occurred in 14.5% of all cases, 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 was associated with a significantly higher risk of mortality across all stroke types, indicating that vomiting can be an early predictor of poor outcomes in stroke patients.

Vomiting in Ischemic Brainstem Strokes

In ischemic strokes involving the lower brainstem, vomiting can be a prominent symptom even when other neurological abnormalities are minimal or absent. This can lead to misdiagnosis as a gastrointestinal disorder, highlighting the need for careful clinical evaluation. The case of a 52-year-old man who experienced severe vomiting without other typical stroke symptoms underscores the importance of considering stroke in differential diagnoses when patients present with unexplained vomiting.

Perioperative Vomiting and Stroke in Moyamoya Patients

In pediatric patients with moyamoya disease undergoing revascularization surgery, vomiting is a common postoperative complication that can lead to acute changes in intracranial pressure and cerebral blood flow. Implementing a standardized perioperative nausea and vomiting protocol significantly reduced the incidence of perioperative strokes in these patients . This finding suggests that effective management of vomiting can play a crucial role in preventing stroke in high-risk surgical patients.

Cyclic Vomiting Syndrome Post-Stroke

Cyclic vomiting syndrome (CVS), characterized by recurrent episodes of vomiting separated by symptom-free periods, can develop after a stroke. A case study reported a 69-year-old woman who developed CVS following a left cerebral infarct. The diagnosis was confirmed after excluding other potential causes, and the patient's symptoms were well-controlled with imipramine hydrochloride. This case highlights the need for awareness of CVS as a potential post-stroke complication.

Challenges in Stroke Diagnosis Due to Vomiting

Vomiting, along with other less specific symptoms like dizziness and changes in mental status, can complicate the accurate diagnosis of stroke by emergency medical services (EMS). A systematic review found that 26% of stroke patients were not initially identified by EMS, with vomiting being a common symptom in these false-negative cases. This underscores the importance of improving stroke recognition protocols to include a broader range of symptoms.

Impact of Vomiting on Stroke Treatment Timelines

The presence of vomiting in stroke patients can delay treatment initiation. A study on acute ischemic stroke (AIS) patients found that those presenting with nausea/vomiting had longer onset-to-needle times for intravenous thrombolysis (IVT) and longer door-to-needle times for endovascular treatment (EVT). This delay in treatment can adversely affect patient outcomes, emphasizing the need for prompt recognition and management of vomiting in stroke patients.

Unique Stroke Symptoms in Women

Women often experience unique stroke symptoms, including nausea and vomiting, more frequently than men. These symptoms are associated with delayed recognition and treatment, leading to poorer outcomes. Current stroke assessment tools may not adequately capture these unique symptoms, highlighting the need for more sensitive and specific diagnostic criteria for women.

Conclusion

Vomiting is a significant symptom in stroke patients that can predict poor outcomes, complicate diagnosis, and delay treatment. Recognizing and managing vomiting effectively is crucial in improving stroke care and outcomes. Enhanced diagnostic protocols and tailored treatment strategies are essential to address the challenges posed by vomiting in stroke patients.