title: Bronchorrhea following Stroke.
abstract: BACKGROUND
  Stroke-induced excessive bronchial secretion is not rare, but seldom discussed. This study emphasizes its recognition, pathophysiology and treatment.
  
  
  METHODS
  We prospectively collected data from 19 consecutive stroke patients with bronchorrhea who were admitted within 2 days of stroke onset.
  
  
  RESULTS
  Sixteen of them (84%) suffered from ischemic stroke, and 3 patients (16%) had hemorrhage. All of them had brainstem involvement, and 11 of them (58%) had localized lesions in the dorsal lateral medulla. In 15 patients (79%), copious secretion developed within 3 days after stroke onset. The frequency of expectoration was variable with fluctuation, and half of the patients (47%) had to spit every 2-5 min during its climax. The duration of increased secretion ranged from 4 days to over 2 months. Half of the patients (53%) received anticholinergic treatment, and the response was fair to good.
  
  
  CONCLUSIONS
  Our data provide clinical evidence that stroke patients with dorsal medulla involvement might present with bronchorrhea which seemed to be mediated via a parasympathetic mechanism. This is a treatable disease, and early diagnosis and treatment may greatly reduce patients' suffering, avoid antibiotics abuse, reduce the incidence of aspiration pneumonia, and shorten the length of hospitalization.
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC. sung0597@cgmh.org.tw
authors.forename: Chung-Yang
authors.initials: CY
authors.lastname: Sung
authors.forename: Tsong-Hai
authors.initials: TH
authors.lastname: Lee
authors.forename: Nai-Shin
authors.initials: NS
authors.lastname: Chu
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000150:complications*; D002543:Cerebral Hemorrhage / Q000150:complications*; D003371:Cough / Q000209:etiology; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000150:complications*