title: Successful treatment of pulmonary aspiration due to brain stem infarction by using cough exercise based on swallowing scintigraphy: preliminary observations.
abstract: Although dysphagia in stroke may result in lethal chest infection, it can be prevented by coughing. We report on a patient with dysphagia and aspiration who regained oral ingestion by swallowing with voluntary cough. A 54-year-old man with subarachnoidal hemorrhage underwent endovascular coiling and developed brain stem infarction. Scintigraphy showed pulmonary aspiration just after swallowing, but no radioactivity was detected in the lungs 10 min after swallowing with voluntary cough. Swallowing exercise with voluntary cough resulted in a safe swallow without enteral feeding. Even if laryngeal penetration and pulmonary aspiration are observed, chest infection could be prevented by swallowing exercise combined with voluntary cough.
authors.affiliation: Department of Rehabilitation Medicine, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyama, Iruma, Saitama, 350-0495, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Kanai
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kurabayashi
authors.forename: Natsumi
authors.initials: N
authors.lastname: Nakamata
authors.forename: Etsuko
authors.initials: E
authors.lastname: Yamamoto
authors.forename: Akiko
authors.initials: A
authors.lastname: Hishinuma
authors.forename: Eiji
authors.initials: E
authors.lastname: Suzuki
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Majima
mesh_terms: D020526:Brain Stem Infarctions / Q000150:complications*; D003371:Cough / Q000503:physiopathology; D003679:Deglutition / Q000502:physiology; D005081:Exercise Therapy / Q000379:methods; D006801:Humans; D057045:Laryngopharyngeal Reflux / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D016896:Treatment Outcome