Dysphagia in patients with acute striatocapsular hemorrhage.
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Dysphagia in patients with acute striatocapsular hemorrhage. / Suntrup, Sonja; Warnecke, Tobias; Kemmling, Andre; Teismann, Inga Kristina; Hamacher, Christina; Oelenberg, Stefan; Dziewas, Rainer.
in: J NEUROL, Jahrgang 259, Nr. 1, 1, 2012, S. 93-99.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Dysphagia in patients with acute striatocapsular hemorrhage.
AU - Suntrup, Sonja
AU - Warnecke, Tobias
AU - Kemmling, Andre
AU - Teismann, Inga Kristina
AU - Hamacher, Christina
AU - Oelenberg, Stefan
AU - Dziewas, Rainer
PY - 2012
Y1 - 2012
N2 - Dysphagia is found in up to 80% of acute stroke patients. To date most studies have focused on ischemic stroke only. Little is known about the incidence and pattern of dysphagia in hemorrhagic stroke. Here we describe the characteristics of dysphagia in patients with striatocapsular hemorrhage. Fiberoptic Endoscopic Evaluation of Swallowing (FEES) was carried out in 30 patients with acute striatocapsular hemorrhage. Dysphagia was classified according to the six-point Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS) within 72 h after admission. Lesion volume, hemisphere and occurrence of ventricular rupture were determined from computer tomography scans. Data on initial NIH-SS, clinical symptoms, need for endotracheal intubation, diagnosis of pneumonia and feeding status on discharge were recorded. Swallowing impairment was observed in 76.7% of patients (n = 23). Mean FEDSS score was 3.1 ± 1.5. Main findings were penetration or aspiration of liquids as well as leakage to valleculae and piriform sinus. Incidence of pneumonia was 30.0% (n = 9). Age, NIH-SS and hematoma volume did not correlate with dysphagia severity. None of the clinical characteristics was predictive for dysphagia. On discharge after 12.9 ± 5.3 days, a two-point improvement on the FEDSS was seen in seven patients, (30.4%) and five patients (21.7%) had gained at least one point. In striatocapsular hemorrhage, dysphagia is a common and so far underrecognized symptom. FEES results indicate predominant impairment of oral motor control. Swallowing impairment is not related to other clinical deficits, stroke severity or lesion characteristics. Thus, detailed dysphagia assessment is indicated in all cases.
AB - Dysphagia is found in up to 80% of acute stroke patients. To date most studies have focused on ischemic stroke only. Little is known about the incidence and pattern of dysphagia in hemorrhagic stroke. Here we describe the characteristics of dysphagia in patients with striatocapsular hemorrhage. Fiberoptic Endoscopic Evaluation of Swallowing (FEES) was carried out in 30 patients with acute striatocapsular hemorrhage. Dysphagia was classified according to the six-point Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS) within 72 h after admission. Lesion volume, hemisphere and occurrence of ventricular rupture were determined from computer tomography scans. Data on initial NIH-SS, clinical symptoms, need for endotracheal intubation, diagnosis of pneumonia and feeding status on discharge were recorded. Swallowing impairment was observed in 76.7% of patients (n = 23). Mean FEDSS score was 3.1 ± 1.5. Main findings were penetration or aspiration of liquids as well as leakage to valleculae and piriform sinus. Incidence of pneumonia was 30.0% (n = 9). Age, NIH-SS and hematoma volume did not correlate with dysphagia severity. None of the clinical characteristics was predictive for dysphagia. On discharge after 12.9 ± 5.3 days, a two-point improvement on the FEDSS was seen in seven patients, (30.4%) and five patients (21.7%) had gained at least one point. In striatocapsular hemorrhage, dysphagia is a common and so far underrecognized symptom. FEES results indicate predominant impairment of oral motor control. Swallowing impairment is not related to other clinical deficits, stroke severity or lesion characteristics. Thus, detailed dysphagia assessment is indicated in all cases.
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Predictive Value of Tests
KW - Prognosis
KW - Deglutition
KW - Tomography, X-Ray Computed
KW - Data Interpretation, Statistical
KW - Functional Laterality
KW - Cerebral Ventricles/pathology
KW - Corpus Striatum/pathology
KW - Deglutition Disorders/etiology
KW - Internal Capsule/pathology
KW - Intracranial Hemorrhages/complications
KW - Neuroendoscopy
KW - Optical Fibers
KW - Parenteral Nutrition
KW - Pneumonia/complications
KW - Stroke/complications/etiology/rehabilitation
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Predictive Value of Tests
KW - Prognosis
KW - Deglutition
KW - Tomography, X-Ray Computed
KW - Data Interpretation, Statistical
KW - Functional Laterality
KW - Cerebral Ventricles/pathology
KW - Corpus Striatum/pathology
KW - Deglutition Disorders/etiology
KW - Internal Capsule/pathology
KW - Intracranial Hemorrhages/complications
KW - Neuroendoscopy
KW - Optical Fibers
KW - Parenteral Nutrition
KW - Pneumonia/complications
KW - Stroke/complications/etiology/rehabilitation
M3 - SCORING: Journal article
VL - 259
SP - 93
EP - 99
JO - J NEUROL
JF - J NEUROL
SN - 0340-5354
IS - 1
M1 - 1
ER -
