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Relationship Between Subcortical Hemorrhage Size and Characteristics of Dysphagia

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Abstract

The subcortex is an important region in terms of swallowing function that passes fibers from the swallowing center to the cortex. However, studies on the relationship between the hemorrhage size and characteristics of dysphagia were lacking. In the present study, the relationship between subcortical hemorrhage size and characteristics of dysphagia was assessed in patients with subcortical hemorrhage. This study recruited retrospectively 49 subcortical hemorrhage patients with dysphagia. The hemorrhage size was measured and the clinical dysphagia scale (CDS) was used to evaluate the severity of dysphagia. The relationship between CDS score and hemorrhage size was analyzed. Subjects were divided into 2 groups according to average hemorrhage size of the subjects. The CDS scores of the 2 groups were compared and the relationship between each CDS item and hemorrhage size was analyzed. A significant positive correlation was observed between hemorrhage size and total CDS score. Also, a significant correlation was observed when patients over 70 years of age were excluded. The total CDS score in the large hemorrhage group was significantly higher than the CDS score in the small hemorrhage group. The CDS items including tracheostomy, lip sealing, tongue protrusion, laryngeal elevation, and reflex coughing were significantly correlated with hemorrhage size. In this study, the hemorrhage size in patients with subcortical hemorrhage correlated with the severity of dysphagia. In addition, the hemorrhage size was correlated with specific CDS items. These findings should be considered when treating subcortical hemorrhage patients with dysphagia in a clinical setting.

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Abbreviations

CDS:

Clinical dysphagia scale

CT:

Computed tomography

VFSS:

Videofluoroscopic swallowing study

IQR:

Interquantile range

References

  1. Singh S, Hamdy S. Dysphagia in stroke patients. Postgrad Med J. 2006;82:383–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Holas MA, DePippo KL, Reding MJ. Aspiration and relative risk of medical complications following stroke. Arch Neurol. 1994;51:1051–3.

    Article  CAS  PubMed  Google Scholar 

  3. Kidd D, Lawson J, Nesbitt R, MacMahon J. The natural history and clinical consequences of aspiration in acute stroke. QJM. 1995;88:409–13.

    CAS  PubMed  Google Scholar 

  4. Katzan IL, Cebul RD, Husak SH, Dawson NV, Baker DW. The effect of pneumonia on mortality among patients hospitalized for acute stroke. Neurology. 2003;60:620–5.

    Article  CAS  PubMed  Google Scholar 

  5. Horner J, Massey EW. Silent aspiration following stroke. Neurology. 1988;38:317–9.

    Article  CAS  PubMed  Google Scholar 

  6. Paciaroni M, Mazzotta G, Corea F, Caso V, Venti M, Milia P, Silvestrelli G, Palmerini F, Parnetti L, Gallai V. Dysphagia following stroke. Eur Neurol. 2004;51:162–7.

    Article  PubMed  Google Scholar 

  7. Robbins J, Levine RL, Maser A, Rosenbek JC, Kempster GB. Swallowing after unilateral stroke of the cerebral cortex. Arch Phys Med Rehabil. 1993;74:1295–300.

    Article  CAS  PubMed  Google Scholar 

  8. Daniels SK, Foundas AL. Lesion localization in acute stroke patients with risk of aspiration. J Neuroimaging. 1999;9:91–8.

    Article  CAS  PubMed  Google Scholar 

  9. Steinhagen V, Grossmann A, Benecke R, Walter U. Swallowing disturbance pattern relates to brain lesion location in acute stroke patients. Stroke. 2009;40:1903–6.

    Article  PubMed  Google Scholar 

  10. Logemann JA, Shanahan T, Rademaker AW, Kahrilas PJ, Lazar R, Halper A. Oropharyngeal swallowing after stroke in the left basal ganglion/internal capsule. Dysphagia. 1993;8:230–4.

    Article  CAS  PubMed  Google Scholar 

  11. Wan P, Chen X, Zhu L, Xu S, Huang L, Li X, Ye Q, Ding R. Dysphagia post subcortical and supratentorial stroke. J Stroke Cerebrovasc Dis. 2016;25:74–82.

    Article  PubMed  Google Scholar 

  12. Nakagawa T, Sekizawa K, Arai H, Kikuchi R, Manabe K, Sasaki H. High incidence of pneumonia in elderly patients with basal ganglia infarction. Arch Intern Med. 1997;157:321–4.

    Article  CAS  PubMed  Google Scholar 

  13. Broderick JP, Brott TG, Duldner JE, Tomsick T, Huster G. Volume of intracerebral hemorrhage. A powerful and easy-to-use predictor of 30-day mortality. Stroke. 1993;24:987–93.

    Article  CAS  Google Scholar 

  14. Franke CL, Versteege CW, van Gijn J. The best fit method. A simple way for measuring the volume of an intracerebral haematoma. Neuroradiology. 1988;30:73–5.

    Article  CAS  PubMed  Google Scholar 

  15. Steiner I, Gomori JM, Melamed E. The prognostic value of the CT scan in conservatively treated patients with intracerebral hematoma. Stroke. 1984;15:279–82.

    Article  CAS  PubMed  Google Scholar 

  16. Tuhrim S, Dambrosia JM, Price TR, Mohr JP, Wolf PA, Hier DB, Kase CS. Intracerebral hemorrhage: external validation and extension of a model for prediction of 30-day survival. Ann Neurol. 1991;29:658–63.

    Article  CAS  PubMed  Google Scholar 

  17. Kothari RU, Brott T, Broderick JP, Barsan WG, Sauerbeck LR, Zuccarello M, Khoury J. The ABCs of measuring intracerebral hemorrhage volumes. Stroke. 1996;27:1304–5.

    Article  CAS  PubMed  Google Scholar 

  18. Han T, Paik N, Park J. The clinical functional scale for dysphagia in stroke patients. Korean J Stroke. 2001;3:153–7.

    Google Scholar 

  19. Chun SW, Lee SA, Jung IY, Beom J, Han TR, Oh BM. Inter-rater agreement for the clinical dysphagia scale. Ann Rehabil Med. 2011;35:470–6.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Jung SH, Lee KJ, Hong JB, Han TR. Validation of clinical dysphagia scale: based on videofluoroscopic swallowing study. J Korean Acad Rehabil Med. 2005;29:343–50.

    Google Scholar 

  21. Daniels SK, Brailey K, Foundas AL. Lingual discoordination and dysphagia following acute stroke: analyses of lesion localization. Dysphagia. 1999;14:85–92.

    Article  CAS  PubMed  Google Scholar 

  22. Daniels SK, Foundas AL. The role of the insular cortex in dysphagia. Dysphagia. 1997;12:146–56.

    Article  CAS  PubMed  Google Scholar 

  23. Martin RE, Goodyear BG, Gati JS, Menon RS. Cerebral cortical representation of automatic and volitional swallowing in humans. J Neurophysiol. 2001;85:938–50.

    Article  CAS  PubMed  Google Scholar 

  24. Mosier K, Bereznaya I. Parallel cortical networks for volitional control of swallowing in humans. Exp Brain Res. 2001;140:280–9.

    Article  CAS  PubMed  Google Scholar 

  25. Cola MG, Daniels SK, Corey DM, Lemen LC, Romero M, Foundas AL. Relevance of subcortical stroke in dysphagia. Stroke. 2010;41:482–6.

    Article  PubMed  Google Scholar 

  26. Lee CK, Kim JA. Pattern of post-stroke swallowing disorder according to the brain lesion. J Korean Acad Rehabil Med. 2001;25:193–201.

    Google Scholar 

  27. Alberts MJ, Horner J, Gray L, Brazer SR. Aspiration after stroke: lesion analysis by brain MRI. Dysphagia. 1992;7:170–3.

    Article  CAS  PubMed  Google Scholar 

  28. Kim J, Oh BM, Kim JY, Lee GJ, Lee SA, Han TR. Validation of the videofluoroscopic dysphagia scale in various etiologies. Dysphagia. 2014;29:438–43.

    Article  PubMed  Google Scholar 

  29. Splaingard ML, Hutchins B, Sulton LD, Chaudhuri G. Aspiration in rehabilitation patients: videofluoroscopy vs bedside clinical assessment. Arch Phys Med Rehabil. 1988;69:637–40.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, Hanyang University College of Medicine, Seoul, Korea

    Sung Young Lee & Seung Hoon Han

  2. Department of Rehabilitation Medicine, Hanyang University Guri Hospital, Kyoungchun-ro 153, Guri-si, Kyeonggi-do, 11923, Republic of Korea

    Seung Hoon Han

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  1. Sung Young Lee
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Correspondence to Seung Hoon Han.

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Lee, S.Y., Han, S.H. Relationship Between Subcortical Hemorrhage Size and Characteristics of Dysphagia. Dysphagia 34, 155–160 (2019). https://doi.org/10.1007/s00455-018-9938-z

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