Cerebral Infarction And Dysphagia

Background Stroke is the leading cause of mortality and morbidity in neurology department.Aspiration pneumonia is common in patients of poststroke,which make poor outcomes,such as death and disability.There are 40 percent of stroke patients suffer dysphagia.As we all known,the brain lesion in brainstem or bilateral cortex can cause dysphagia.But I observed that many stroke patients with unilateral cerebral hemisphere also had dysphagia,the mechanism of which was studied widely in the past 10 years.And scientists proposed hypothesis that swallow is controlled by many areas of cortex which are asymmetry in different hemisphere.When the pharyngeal motor representation of affected hemisphere is superior,the dysphagia occurs. However,there are still some unknown about the exact location of cortex leading to swallowing difficulty.Aim We mainly study the areas of cortex that control swallowing by analyzing the relationship between the dysphagia patients and the infarction locations.Methods The 91 patients studied had unilateral hemisphere stroke confirmed by MRI.And 30 patients had dysphagia.The dysphagia was assessed by standardized clinical methods.The exact location of infarction was determined on MRI.Compare the difference of lesions in brain between dysphagia patients and non-dysphagia ones using SPSS 16.0 software.Results 33%of 91 patients had dysphagia.Dysphagia was more frequent in patients with temporal lobe infarction(8 VS.4;p＜0.05).There was little difference between dysphagia patients and non-dysphagia ones in areas of frontal lobe,basal ganglia, occipital lobe,insula and so on.NIHSS was higher in dysphagia patients than non-dysphagia ones(7.9±3.97 VS.3.5±2.4;p＜0.01).Dysphagia had nothing to do with left or right hemisphere infarction.Conclusion About approximately one third patients with unilateral cerebral infarction have dysphagia.Swallowing difficulty is frequent in temporal lobe infarction,and has little correlation with other cerebral infarction locations.NIHSS in dysphagia patients are significantly higher than non-dysphagia ones,which indicates that dysphagia may be related with infarction size and severity of neurologic dificits.