Relationship Between Subcortical Hemorrhage Size and Characteristics of Dysphagia

Dysphagia. 2019 Apr;34(2):155-160. doi: 10.1007/s00455-018-9938-z. Epub 2018 Aug 25.

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.

Keywords: Clinical dysphagia scale (CDS); Dysphagia; Subcortical hemorrhage.

MeSH terms

  • Aged
  • Cerebral Cortex / pathology
  • Cerebral Hemorrhage / complications
  • Cerebral Hemorrhage / pathology*
  • Cerebral Hemorrhage / physiopathology
  • Deglutition / physiology
  • Deglutition Disorders / etiology
  • Deglutition Disorders / pathology*
  • Deglutition Disorders / physiopathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies