Correlation between brain injury and dysphagia in adult patients with stroke

Maria Cristina de Alencar Nunes; Ari Leon Jurkiewicz; Rosane Sampaio Santos; Ana Maria Furkim; Giselle Massi; Gisele Sant Ana Pinto; Marcos Christiano Lange

doi:10.7162/S1809-97772012000300003

International Archives of Otorhinolaryngology, Table of Contents

Int Arch Otorhinolaryngol 2012; 16(03): 313-321
DOI: 10.7162/S1809-97772012000300003

Original Article

Thieme Publicações Ltda Rio de Janeiro, Brazil

Correlation between brain injury and dysphagia in adult patients with stroke

Maria Cristina de Alencar Nunes

¹Speech Therapist. Student Doctorate in Internal Medicine from the Universidade Federal do Paraná (HC-UFPR). Professor of the Specialization Course on Dysphagia and Voice of the University Tuiuti do Paraná – Curitiba/PR.

,

Ari Leon Jurkiewicz

²Geriatrician. Doctor of Sciences from the UNIFESP / EPM. Professor of Masters and Doctorate in Communication Disorders at the University Tuiuti - Curitiba/PR.

,

Rosane Sampaio Santos

³Speech Therapist. Student Doctorate in Internal Medicine from the Universidade Federal do Paraná (HC-UFPR). Professor of Masters and Doctorate in Communication Disorders at the University Tuiuti - Curitiba/PR.

,

Ana Maria Furkim

⁴Speech Therapist. Doctor in Human Communication Disorders from the Federal University of Sao Paulo. Professor of Speech Pathology, Federal University of Santa Catarina/SC.

,

Giselle Massi

⁵Speech Therapist. Doctor in Linguistics from the Universidade Federal do Paraná (UFPR). Professor of Masters and Doctorate in Communication Disorders at the University Tuiuti - Curitiba/PR.

,

Gisele Sant Ana Pinto

⁶Speech Therapist. Student Master in Internal Medicine from the Universidade Federal do Paraná (HC-UFPR) - Curitiba/PR.

,

Marcos Christiano Lange

⁷Neurologist. Doctor in Internal Medicine from the Universidade Federal do Paraná (HC-UFPR) - Curitiba/PR.

› Author Affiliations

Abstract

Summary

Introduction: In the literature, the incidence of oropharyngeal dysphagia in patients with cerebrovascular accident (AVE) ranges 20–90%. Some studies correlate the location of a stroke with dysphagia, while others do not.

Objective: To correlate brain injury with dysphagia in patients with stroke in relation to the type and location of stroke.

Method: A prospective study conducted at the Hospital de Clinicas with 30 stroke patients: 18 women and 12 men. All patients underwent clinical evaluation and swallowing nasolaryngofibroscopy (FEES^®), and were divided based on the location of the injury: cerebral cortex, cerebellar cortex, subcortical areas, and type: hemorrhagic or transient ischemic.

Results: Of the 30 patients, 18 had ischemic stroke, 10 had hemorrhagic stroke, and 2 had transient stroke. Regarding the location, 10 lesions were in the cerebral cortex, 3 were in the cerebral and cerebellar cortices, 3 were in the cerebral cortex and subcortical areas, and 3 were in the cerebral and cerebellar cortices and subcortical areas. Cerebral cortex and subcortical area ischemic strokes predominated in the clinical evaluation of dysphagia. In FEES^®, decreased laryngeal sensitivity persisted following cerebral cortex and ischemic strokes. Waste in the pharyngeal recesses associated with epiglottic valleculae predominated in the piriform cortex in all lesion areas and in ischemic stroke. A patient with damage to the cerebral and cerebellar cortices from an ischemic stroke exhibited laryngeal penetration and tracheal aspiration of liquid and honey.

Conclusion: Dysphagia was prevalent when a lesion was located in the cerebral cortex and was of the ischemic type.

Keywords

stroke - deglutition disorders - ischemic attack - transient.

Full Text

References

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