Dysphagia following Stroke.
BACKGROUND
Dysphagia is common after stroke. We aimed to study the prognosis of dysphagia (assessed clinically) over the first 3 months after acute stroke and to determine whether specific neurovascular-anatomical sites were associated with swallowing dysfunction.


METHODS
We prospectively examined consecutive patients with acute first-ever stroke. The assessment of dysphagia was made using standardized clinical methods. The arterial territories involved were determined on CT/MRI. All patients were followed up for 3 months.


RESULTS
34.7% of 406 patients had dysphagia. Dysphagia was more frequent in patients with hemorrhagic stroke (31/63 vs. 110/343; p = 0.01). In patients with ischemic stroke, the involvement of the arterial territory of the total middle cerebral artery was more frequently associated with dysphagia (28.2 vs. 2.2%; p < 0.0001). Multivariate analysis revealed that stroke mortality and disability were independently associated with dysphagia (p < 0.0001).


CONCLUSIONS
The frequency of dysphagia was relatively high. Regarding anatomical-clinical correlation, the most important factor was the size rather than the location of the lesion. Dysphagia assessed clinically was a significant variable predicting death and disability at 90 days.
Paciaroni
Maurizio
M
Stroke Unit, Department of Neuroscience, University of Perugia, Perugia, Italy. mpaciaroni@libero.it
Mazzotta
Giovanni
G
Corea
Francesco
F
Caso
Valeria
V
Venti
Michele
M
Milia
Paolo
P
Silvestrelli
Giorgio
G
Palmerini
Francesco
F
Parnetti
Lucilla
L
Gallai
Virgilio
V
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003680:Deglutition Disorders / Q000209:etiology* / Q000473:pathology; D004185:Disability Evaluation; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000473:pathology; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods