Dysphagia Post Subcortical and Supratentorial Stroke.
BACKGROUND
Studies have recognized that the damage in the subcortical and supratentorial regions may affect voluntary and involuntary aspects of the swallowing function. The current study attempted to explore the dysphagia characteristics in patients with subcortical and supratentorial stroke.


METHODS
Twelve post first or second subcortical and supratentorial stroke patients were included in the study. The location of the stroke was ascertained by computed tomography and magnetic resonance imaging. The characteristics of swallowing disorder were assessed by video fluoroscopic swallowing assessment/fiberoptic endoscopic evaluation of swallowing. The following main parameters were analyzed: oral transit time, pharyngeal delay time, presence of cricopharyngeal muscle achalasia (CMA), distance of laryngeal elevation, the amounts of vallecular residue and pyriform sinus residue (PSR), and the extent of pharyngeal contraction.


RESULTS
Eighty-three percent of the 12 patients were found suffering from pharyngeal dysphagia, with 50% having 50%-100% PSRs, 50% having pharyngeal delay, and 41.6% cases demonstrating CMA. Simple regression analysis showed PSRs were most strongly associated with CMA. Pharyngeal delay in the study can be caused by infarcts of basal ganglia/thalamus, infarcts of sensory tract, infarcts of swallowing motor pathways in the centrum semiovale, or a combination of the three.


CONCLUSIONS
Subcortical and supratentorial stroke may result in pharyngeal dysphagia such as PSR and pharyngeal delay. PSR was mainly caused by CMA.
Department of Speech and Hearing Rehabilitation, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Ping
P
Wan
Department of Ear, Nose and Throat, Yueyang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Xuhui
X
Chen
Department of Radiology, Yueyang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Lequn
L
Zhu
Department of Speech and Hearing Rehabilitation, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Shuangjin
S
Xu
Department of Rehabilitation Medicine, Yueyang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Li
L
Huang
Department of Ear, Nose and Throat, Yueyang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Xiangcui
X
Li
Department of Ear, Nose and Throat, No. 7 Hospital of Shanghai, Shanghai, China.
Qing
Q
Ye
Department of Communication Sciences and Disorders, Elmhurst College, Elmhurst, Illinois. Electronic address: ruiying.ding@elmhurst.edu.
Ruiying
R
Ding
D000344:Afferent Pathways / Q000473:pathology / Q000503:physiopathology; D000368:Aged; D000369:Aged, 80 and over; D001479:Basal Ganglia / Q000503:physiopathology*; D002545:Brain Ischemia / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D002681:China / Q000453:epidemiology; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D004525:Efferent Pathways / Q000473:pathology / Q000503:physiopathology; D004931:Esophageal Achalasia / Q000209:etiology / Q000503:physiopathology; D004945:Esophagoscopy; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007830:Larynx / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010609:Pharyngeal Muscles / Q000503:physiopathology; D056144:Pyriform Sinus / Q000473:pathology; D012189:Retrospective Studies; D059409:Stroke, Lacunar / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D013788:Thalamus / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed; D066127:White Matter / Q000503:physiopathology*
Subcortical and supratentorial stroke; cricopharyngeal muscle achalasia; dysphagia; pharyngeal delay