Eating and Swallowing Problems in Patients with Acute Cerebral Hemorrhage / The Japanese Journal of Rehabilitation Medicine

ABSTRACT

There are many stroke patients who have eating and swallowing problems after stroke, especially in the acute phase. However, little is known about the relationship between lesion, hematoma volume and pattern of dysphagia in hemorrhagic stroke. Accordingly, we evaluated the clinical features of swallowing function in acute cerebral hemorrhage. Four hundred and forty-seven newly diagnosed acute cerebral hemorrhage patients including 183 putamen, 119 thalamus, 30 cerebellum, 25 brainstem, and 90 subcortical hemorrhages were studied. Patients were referred for bedside swallowing assessment (BSA) using the Repetitive Saliva Swallowing Test and the Modified Water Swallowing Test at initial evaluation. Additionally, videofluoroscopy was performed in 129 patients to determine their oral intake status. The type of diet and outcomes were assessed on discharge. As results, most patients with normal BSA were consuming a regular diet on discharge. However, the number of patients who consumed a regular meal amongst the 289 patients with abnormal BSA was very few. Two hundred ten patients were nutritionally managed using enteral feeding. Lesion site and hematoma volume were related to the BSA result and oral intake outcome at discharge. Eating and swallowing dysfunction is not rare in patients with acute cerebral hemorrhage. We therefore recommend that all patients with cerebral hemorrhage should undergo a swallowing assessment and management in the acute stage.