Relationship between dysphagia and the location of brain lesions in acute stroke / 中华老年医学杂志

ABSTRACT

Objective To investigate the relationship between the incidence of dysphagia and the location of brain lesions in patients with acute stroke.Methods Swallowing function was assessed by Watin drinking water test within 48 hours after admission in 226 cases with acute stroke.The location of the brain lesions was identified by CT and / or MRI.According to the US National Institutes of Health Stroke Scale (NIHSS),evaluation of nerve functions was evaluated within 24 hours after admission in stroke patients.Results The incidence of dysphagia was 50.4％ (114 /226) in 226 patients in acute stage.The degree of neurological deficit of stroke patients on admission was significantly correlated with the occurrence of dysphagia (x2 =13.35,P=0.02).The incidence of dysphagia caused by lesions in internal carotid artery trunk (hemisphere in combination with basal ganglia/internal capsule) was more common in anterior circulating territory(internal carotid artery system),dysphagia with internal carotid arterg(ICA) trunk occlusion (hemisphere in combination with basal ganglia/internal capsule) was more common than that caused by cortex branches occlusion (hemisphere-cortex) or penetrating ICA injuries (basal ganglia/internal capsule) and cortex branches occlusion (hemisphere-cortex),respectively(x2 =8.228,P＜0.05).The incidences of dysphagia induced by brain lesions of different cortex lobes had no statistic differences(x2 =0.312,P＞0.05).In posterior circulating territory (vertebro-basilar system),the incidence of swallowing disorders was significantly higher in brain stem group than in the thalamus and cerebellum (x2 =27.292,P＜0.001).The incidence of the dysphagia caused by lesions in cerebral hemispheres,combined basal ganglia / internal capsule and brain stem lesions were significantly higher than those caused by other lesions(x2 =35.639,P＜0.000).Conclusions Brain lesions of hemisphere combined basal ganglia/internal capsule and brain stem are significantly associated with the occurrence of dysphagia after acute stroke.