Vertigo and stroke: A case study

November 4, 2024


 The Vertigo And Dizziness Program™ By Christian Goodman Vertigo and Dizziness Program is a designed to help stop vertigo and dizziness once and for all. Medical practitioner don’t know the exact cure for this condition but this program will show you exactly what you need to make this painful condition a thing of the past. This program has recommended a set of simple head exercises that help cure this condition.


Vertigo and stroke: A case study

Vertigo and Stroke: A Case Study

Patient Profile

  • Name: John Doe
  • Age: 65 years
  • Gender: Male
  • Medical History: Hypertension, hyperlipidemia, and a prior transient ischemic attack (TIA) six months prior. No previous history of vertigo.

Initial Presentation

John presented to the emergency department with complaints of sudden onset vertigo that began two hours earlier. He described the sensation as a spinning feeling that worsened with head movement. Along with vertigo, he reported:

  • Nausea and vomiting
  • Difficulty walking (unsteady gait)
  • Mild right-sided weakness in the arm and leg
  • A noticeable change in his speech, which became slurred

Evaluation

Upon arrival at the emergency department, a rapid assessment was conducted:

  • Neurological Examination: The exam revealed:
    • Right-sided weakness (motor strength 3/5 in the right arm and leg)
    • Slurred speech (dysarthria)
    • Positive finger-to-nose test on the left side
    • Mild dysphagia (difficulty swallowing)
  • Vital Signs: Blood pressure was elevated (180/100 mmHg), heart rate was irregular, and the patient was slightly tachycardic.
  • Imaging: A non-contrast CT scan of the brain was performed, revealing a left-sided ischemic stroke in the posterior circulation affecting the cerebellum and brainstem.

Diagnosis

The combination of sudden-onset vertigo, gait disturbance, slurred speech, and right-sided weakness suggested a cerebellar stroke, likely due to embolic or thrombotic occlusion affecting the posterior inferior cerebellar artery (PICA) or the vertebral artery.

Treatment

John was immediately admitted to the stroke unit for management. The following interventions were initiated:

  1. Acute Management:
    • Intravenous thrombolysis (tPA) was initiated within the appropriate window as his stroke was classified as ischemic.
    • Antihypertensive medication was administered to manage elevated blood pressure.
  2. Supportive Care:
    • Monitoring of neurological status and vital signs.
    • Speech therapy was consulted for evaluation and intervention due to dysarthria and dysphagia.
  3. Rehabilitation:
    • Once stabilized, John began a structured rehabilitation program, including physical and occupational therapy focusing on balance and mobility training.

Outcome

John showed significant improvement over the next few days. His neurological deficits began to resolve, with:

  • Gradual recovery of speech and swallowing functions
  • Reduction in right-sided weakness
  • Ability to ambulate with assistance by the time of discharge

He was discharged to a rehabilitation facility for continued therapy and monitoring.

Follow-Up

During his follow-up appointment one month later, John had:

  • Improved mobility with minimal assistance
  • Residual mild right-sided weakness, but he was able to perform most daily activities independently
  • A comprehensive stroke prevention plan was established, including lifestyle modifications, anticoagulation therapy for atrial fibrillation, and management of cardiovascular risk factors.

Lessons Learned

  1. Recognizing Stroke Symptoms: This case highlights the importance of recognizing the signs of stroke, especially when presenting with vertigo. Patients with sudden-onset vertigo, especially if accompanied by neurological deficits, should be evaluated promptly for possible stroke.
  2. Comprehensive Evaluation: A thorough history and neurological examination are essential in differentiating between peripheral vestibular disorders and central causes such as stroke.
  3. Importance of Timely Intervention: Early recognition and treatment of ischemic stroke can significantly improve outcomes. Understanding the time-sensitive nature of thrombolytic therapy is crucial for healthcare providers.
  4. Patient Education: Educating patients and families about recognizing stroke symptoms can facilitate faster medical attention, potentially minimizing long-term disabilities.

Conclusion

This case study emphasizes the interplay between vertigo and neurological events such as stroke. It reinforces the necessity of prompt assessment and intervention, especially in older adults with risk factors for cerebrovascular disease. Accurate diagnosis and timely management can greatly influence recovery and quality of life post-stroke.


 The Vertigo And Dizziness Program™ By Christian Goodman Vertigo and Dizziness Program is a designed to help stop vertigo and dizziness once and for all. Medical practitioner don’t know the exact cure for this condition but this program will show you exactly what you need to make this painful condition a thing of the past. This program has recommended a set of simple head exercises that help cure this condition.