Document Detail


Swallowing disturbance pattern relates to brain lesion location in acute stroke patients.
MedLine Citation:
PMID:  19286597     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: The relationship of brain lesion location and swallowing disturbance pattern has been poorly studied in acute stroke patients. METHODS: Sixty patients with first-ever acute ischemic stroke at clearly assessed location and clinical signs of dysphagia were studied. Swallowing-related parameters rated clinically and fiberendoscopically were attention deficit, buccofacial apraxia, orofacial paresis, gag reflex, delay of pharyngeal swallow, pharyngeal contraction, larynx elevation, function of upper esophageal sphincter (UES), and aspiration severity. RESULTS: Attention deficit was independently predicted only by parietotemporal infarction, buccofacial apraxia by left-sided parietotemporal infarction, orofacial paresis by infarction encompassing upper motor neuron of cranial nerves, and impaired UES opening by lateral medullary infarction. Other swallowing parameters were not related to lesion topology. On posthoc analysis, pneumonia within 21 days after stroke was predicted only by insular lesion. CONCLUSIONS: Distinct acute brain lesion locations result in characteristic swallowing disturbance patterns. Dysphagic patients with insular stroke appear to have even higher risk of pneumonia suggesting a further associated factor promoting infection in these subjects.
Authors:
Volker Steinhagen; Annette Grossmann; Reiner Benecke; Uwe Walter
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Publication Detail:
Type:  Journal Article     Date:  2009-03-12
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  40     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-28     Completed Date:  2009-05-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1903-6     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Rostock, Rostock, Germany.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Aged, 80 and over
Brain / pathology*
Cerebral Infarction / complications,  pathology
Deglutition Disorders / etiology*,  pathology*
Female
Humans
Logistic Models
Male
Middle Aged
Optical Fibers
Paralysis / etiology
Prospective Studies
Stroke / complications*,  pathology*,  psychology
Treatment Outcome
Comments/Corrections
Comment In:
Stroke. 2009 May;40(5):1555-6   [PMID:  19286586 ]

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


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