Document Detail


Lesion localization in acute stroke patients with risk of aspiration.
MedLine Citation:
PMID:  10208106     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of this prospective study was to determine whether specific neuroanatomical sites were associated with increased risk of aspiration in acute stroke patients. Videofluoroscopic swallow studies (VSS) and computed tomography or magnetic resonance imaging scans were completed on consecutive male stroke patients (n = 54). Videofluoroscopic swallow studies were scored on a scale from 0 (normal swallowing) to 4 (severe dysphagia). Patients with scores of 0-1 were grouped together as having no risk of aspiration, and patients with scores of 2-4 were grouped together as having a risk of aspiration. Lesion analyses revealed that location appeared to be more critical than hemisphere or lesion size in predicting patients at risk of aspiration. Anterior locations and subcortical periventricular white matter sites were commonly lesioned in patients with risk of aspiration, whereas patients without risk of aspiration were more likely to have posterior lesions and lesions to subcortical gray matter structures. These data demonstrate that swallowing appears to be mediated by a distributed neural network that involves both cerebral hemispheres with descending input to the medulla; however, specific lesion locations may put patients at a greater risk of aspiration.
Authors:
S K Daniels; A L Foundas
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of neuroimaging : official journal of the American Society of Neuroimaging     Volume:  9     ISSN:  1051-2284     ISO Abbreviation:  J Neuroimaging     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-05-03     Completed Date:  1999-05-03     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9102705     Medline TA:  J Neuroimaging     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  91-8     Citation Subset:  IM    
Affiliation:
Speech Pathology Service, Department of Veterans Affairs Medical Center, New Orleans, LA 70146, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Aged, 80 and over
Brain / pathology*
Brain Stem / pathology
Cerebrovascular Disorders / complications,  pathology*
Cineradiography
Corpus Callosum / pathology
Deglutition / physiology
Deglutition Disorders / etiology*,  physiopathology
Fluoroscopy
Forecasting
Foreign Bodies / etiology
Humans
Larynx
Magnetic Resonance Imaging
Male
Medulla Oblongata / pathology
Middle Aged
Mouth / physiopathology
Nerve Net / pathology
Pharynx / physiopathology
Prospective Studies
Risk Factors
Tomography, X-Ray Computed
Video Recording
Grant Support
ID/Acronym/Agency:
K08 DC00135/DC/NIDCD NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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