Dysphagia Post Subcortical and Supratentorial Stroke

详细信息    查看全文

• 作者：Ping Wan ; MD ; PhD^* ; Xuhui Chen ; MD^&dagger ; ; Lequn Zhu ; MD^&Dagger ; ; Shuangjin Xu ; MD^* ; Li Huang ; MD^§ ; ; Xiangcui Li ; MD^&dagger ; ; Qing Ye ; MD ; PhD^‖ ; Ruiying Ding ; PhD^¶ ; ; ^{ruiying.ding@elmhurst.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Subcortical and supratentorial stroke ; dysphagia ; cricopharyngeal muscle achalasia ; pharyngeal delay
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：25
• 期：1
• 页码：74-82
• 全文大小：138 K

文摘

Studies have recognized that the damage in the subcortical and supratentorial regions may affect voluntary and involuntary aspects of the swallowing function. The current study attempted to explore the dysphagia characteristics in patients with subcortical and supratentorial stroke.

Methods

Twelve post first or second subcortical and supratentorial stroke patients were included in the study. The location of the stroke was ascertained by computed tomography and magnetic resonance imaging. The characteristics of swallowing disorder were assessed by video fluoroscopic swallowing assessment/fiberoptic endoscopic evaluation of swallowing. The following main parameters were analyzed: oral transit time, pharyngeal delay time, presence of cricopharyngeal muscle achalasia (CMA), distance of laryngeal elevation, the amounts of vallecular residue and pyriform sinus residue (PSR), and the extent of pharyngeal contraction.

Results

Eighty-three percent of the 12 patients were found suffering from pharyngeal dysphagia, with 50% having 50%-100% PSRs, 50% having pharyngeal delay, and 41.6% cases demonstrating CMA. Simple regression analysis showed PSRs were most strongly associated with CMA. Pharyngeal delay in the study can be caused by infarcts of basal ganglia/thalamus, infarcts of sensory tract, infarcts of swallowing motor pathways in the centrum semiovale, or a combination of the three.

Conclusion

Subcortical and supratentorial stroke may result in pharyngeal dysphagia such as PSR and pharyngeal delay. PSR was mainly caused by CMA.