Dizziness in Stroke Patients: Signs of a New Stroke?

Dizziness recurrence in stroke patients?

Hello Dr.
Huang,
My mother is 58 years old and suffered a second stroke one year ago, resulting in multiple infarcts in the brainstem and cerebellum, which caused right-sided hemiplegia, loss of balance, and unclear speech, although her consciousness has been clear.
Over the past year, her condition has been stable, and she has been undergoing continuous rehabilitation.
However, in the last two weeks, she has started experiencing frequent dizziness (which was also a symptom during her initial stroke).
Her blood pressure measurements have been lower than usual, but her blood sugar levels are normal.

Could you please advise if sudden low blood pressure leading to frequent dizziness could be a precursor to another stroke, or could it be due to other reasons? Thank you for taking the time to respond.

Sunny, 20~29 year old female. Ask Date: 2006/05/23

Dr. Huang Yingzhe reply Neurology

Dear Sunny,
It is possible! However, there may also be other causes for the dizziness/lightheadedness.
It is essential for your attending physician to conduct an evaluation to obtain an accurate diagnosis.
The Tainan City Hospital cares about your health.

Sincerely,
Dr.
Huang Ying-Che
Department of Neurology
Tainan City Hospital

Reply Date: 2006/05/23

More Info

Dizziness in stroke patients can be a concerning symptom, especially in someone with a history of strokes. In your mother's case, her recent episodes of dizziness, combined with a history of multiple strokes, warrant careful evaluation. While dizziness can be a sign of a new stroke, it can also be attributed to various other causes, particularly in individuals with a complex medical history.

Firstly, it is essential to understand that dizziness can manifest in different forms, including vertigo (a spinning sensation), lightheadedness, or a feeling of imbalance. In stroke patients, dizziness may indicate a new ischemic event, particularly if it is accompanied by other neurological symptoms such as weakness, speech difficulties, or changes in consciousness. Given that your mother experienced dizziness before her initial strokes, it is crucial to consider this symptom seriously.

The fact that her blood pressure readings have been lower than usual could also be a contributing factor to her dizziness. Low blood pressure (hypotension) can lead to insufficient blood flow to the brain, resulting in dizziness or lightheadedness. This situation can be exacerbated by dehydration, medication side effects, or other underlying health issues. It is important to monitor her blood pressure regularly and consult with her healthcare provider to determine the cause of these fluctuations.

In the context of stroke, low blood pressure can sometimes be a sign of a more significant issue, such as a new stroke or a transient ischemic attack (TIA), often referred to as a "mini-stroke." TIAs can present with symptoms similar to those of a stroke but typically resolve within 24 hours. They are significant warning signs indicating an increased risk of a future stroke. Therefore, if your mother’s dizziness persists or worsens, it is crucial to seek immediate medical attention.

Other potential causes of dizziness in stroke patients include vestibular disorders, medication side effects, or even anxiety and stress, which can be common in individuals dealing with the aftermath of a stroke. It is also worth considering whether any recent changes in her medications or health status could be contributing to her symptoms.

In summary, while dizziness can be a sign of a new stroke, it is not the only possibility. Given your mother's history of strokes and her recent symptoms, it is essential to consult her healthcare provider for a thorough evaluation. This may include imaging studies, blood tests, and a review of her medications to rule out any serious complications or new strokes. Early intervention is key in managing stroke risk and ensuring the best possible outcomes for patients with a history of cerebrovascular events.

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