Electrolyte Imbalance in Patients Suffering from Acute Stroke in India: An Article Review

Background Electrolyte imbalance is a frequent yet often under diagnosed complication in patients presenting with acute stroke. It has significant implications for patient outcomes, particularly in resource-limited settings like India, where delays in diagnosis and treatment may worsen prognosis. Objective To review the prevalence, types, pathophysiological mechanisms, clinical impact, diagnostic challenges, and management of electrolyte imbalances among acute stroke patients in the Indian population. Methods A comprehensive literature review was conducted, focusing on peer-reviewed Indian studies and international data reporting electrolyte disturbances in acute stroke patients. Emphasis was placed on sodium, potassium, calcium, and magnesium derangements, particularly hyponatremia due to SIADH and cerebral salt wasting (CSWS). Results Hyponatremia emerged as the most prevalent abnormality, reported in 20–40% of Indian stroke patients, followed by hypokalemia (10–15%) and hypernatremia (6–10%). SIADH and CSWS are major contributors to sodium imbalance. These abnormalities are associated with increased stroke severity, longer hospital stays, higher rates of ICU admission, and elevated mortality. Variability in diagnostic and treatment practices across urban and rural settings contributes to inconsistent outcomes. Conclusion Electrolyte disturbances, especially sodium and potassium imbalances, significantly affect the clinical trajectory of stroke patients in India. Timely recognition, differentiation between SIADH and CSWS, and appropriate correction are vital to reducing complications and improving recovery. Integration of standard electrolyte management protocols in stroke care is urgently needed, particularly in primary and secondary healthcare centers.