Association Between Duration of Dysphagia Recovery and Lesion Location on Magnetic Resonance Imaging in Patients With Middle Cerebral Artery Infarction

Abstract

Objective To investigate association between lesion location on magnetic resonance imaging (MRI) performed after an infarction and the duration of dysphagia in middle cerebral artery (MCA) infarction. Methods A videofluoroscopic swallowing study was performed for 59 patients with dysphagia who were diagnosed as cerebral infarction of the MCA territory confirmed by brain MRI. Lesions were divided into 11 regions of interest: primary somatosensory cortex, primary motor cortex, supplementary motor cortex, anterior cingulate cortex, orbitofrontal cortex, parieto-occipital cortex, insular cortex, posterior limb of the internal capsule (PLIC), thalamus, basal ganglia (caudate nucleus), and basal ganglia (putamen). Recovery time was defined as the period from the first day of L-tube feeding to the day that rice porridge with thickening agent was prescribed. Recovery time and brain lesion patterns were compared and analyzed. Results The mean recovery time of all patients was 26.71±16.39 days. The mean recovery time was 36.65±15.83 days in patients with PLIC lesions and 32.6±17.27 days in patients with caudate nucleus lesions. Only these two groups showed longer recovery time than the average recovery time for all patients. One-way analysis of variance for recovery time showed significant differences between patients with and without lesions in PLIC and caudate (p<0.001). Conclusion Injury to both PLIC and caudate nucleus is associated with longer recovery time from dysphagia.

Increased activation of the caudate nucleus and parahippocampal gyrus in Parkinson’s disease patients with dysphagia after repetitive transcranial magnetic stimulation: a case-control study

“…The gradient of dopaminergic loss is largely preserved in all PD patients (Pasquini et al, 2019). Im et al (2018) and Kim et al (2019) showed that caudate damage can increase the risk of aspiration and prolong the recovery time of swallowing. Hence, caudate injury is likely involved in the occurrence of dysphagia in PD patients and is potentially associated with gradient changes in dopaminergic loss.…”

Faktor Faktor Risiko terjadinya Pneumonia pada Stroke Akut di RSUP Dr Hasan Sadikin Bandung

“…Hasil ini sesuai dengan penelitian kontrol kasus di Australia 12 yang melaporkan pneumonia lebih sering ditemukan pada stroke infark dengan lokasi di sirkulasi anterior, 12 sejalan dengan penelitian kohort di China 11 juga menyatakan bahwa sirkulasi anterior merupakan faktor independent yang meningkatkan risiko terjadinya pneumonia (OR 1,38). 11 Penelitian retrospektif di Korea 15 menyatakan bahwa infark di sirkulasi anterior berkaitan dengan disfungsi fase oral menelan, 15 dimana infark dengan lokasi di SAT menunjukkan lesi infark besar yang mengenai struktur insular (pada teritori arteri serebri media), dimana lesi pada insular menyebabkan stimulasi simpatis berlebih sehingga mencetuskan imunodepresi yang lebih hebat. 16 Penelitian prospektif observasional di Jerman 16 juga menyatakan bahwa ukuran lesi infark yang besar (58,33%) berkorelasi terhadap kejadian pneumonia (OR 3,5 pada ukuran infark yang besar (> 5cm) atau > 1/3 arteri serebri media).…”

The Contribution of Dysphagia to Acute Stroke Morbidity and Mortality in Nigeria: A Prospective Study

“…[24] Lesions in the cortical areas were not significantly associated with dysphagia in the present study as was found in some other studies. [25,26] Severe stroke was…”