The relationship between dysphagia and the localisation of brain lesion in stroke: is the involvement of the pons and medulla important?

Abstract

Objectives

The presence of dysphagia in stroke is associated with mortality and morbidity. The aim of this retrospective study is to present the relationship between dysphagia and the demographic characteristics of the patient, and the type and localisation of brain lesion in the acute period in stroke patients with dysphagia.

Materials and Methods

The data of 284 patients who had stroke-related dysphagia, had a disease duration 1–3 months, had no history of swallowing dysfunction before the event, and had their brain MRI/CT reports in the hospital were included.

Results

The rate of tube-dependent oral areas was higher in the lesions located in the pons and the medulla than in the lesions located in the MCA cortex, the basal ganglia, and the cerebellum (p ˂ 0.001, p = 0.032 and p = 0.011, respectively) and the percentage of those fed with NG + TPN + PEG was statistically significantly higher (p = 0.002, p = 0.032 and p = 0.011, respectively). History of pneumonia was found to be statistically significantly higher in the lesions located in the pons and the medulla than in the lesions located in the MCA cortex, ACA cortex, PCA cortex, the basal ganglia, periventricular white matter, the thalamus, the cerebellum, and the midbrain (p ˂ 0.001, p = 0.005, p = 0.023, p ˂ 0.001, p = 0.023, p = 0.001, p = 0.011 and p = 0.023, respectively).

Conclusion

In conclusion, although lesion localisation in the acute period in patients with dysphagia varied in terms of clinical swallowing evaluation findings, weight loss, pneumonia history, the rate of tube-dependent intake, were shown to be higher in patients who had lesions in the pons and the medulla, which is a finding that should be considered in the clinical follow-up of acute stroke patients with lesions in the pons and the medulla.

Keywords:

• Dysphagia
• stroke
• brain lesion

Acknowledgement

The authors are indebted to patients for their contributions.

Disclosure statement

No potential conflict of interest was reported by the author(s).

The authors certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organisation with which we are associated and, if applicable, The authors certify that all financial and material support for this research (e.g. NIH or NHS grants) and work are clearly identified in the title page of the manuscript. The manuscript submitted does not contain information about medical device.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.