뇌졸중 병변에 따른 삼킴장애의 양상

Abstract

Objective: To investigate the pattern of dysphagia according to the location of brain lesions. Method: Two hundred and seventy two patients with post-stroke dysphagia underwent a Videofluoroscopic Swallowing Study (VFSS). The brain lesions were classified into infarction and hemorrhage by brain MRI or CT findings, and the location of the brain lesions was subdivided into right and left hemisphere (cortical and subcortical), brainstem, and cerebellum. The dysphagia pattern was analyzed according to stroke location. Result: Patients with left hemispheric or cerebellar stroke showed more frequent abnormal coordination of oral transfer (P＜0.05). Delayed pharyngeal swallowing was seen more frequently in patients with stroke of the left hemisphere and brainstem (P＜0.05). In patients with brainstem or cerebellar stroke, the range of laryngeal excursion was smaller and the bolus retentions in vallecular and piriform sinues were larger than hemispheric stroke. (P＜0.05). Pharyngeal motility was reduced in patients with brainstem or cerebellar lesions. Patients with brainstem stroke had a higher incidence of upper esophageal sphincter dysfunction (P＜0.05). Conclusion: The pattern of dysphagia can be predicted by stroke location, and it will be of beneficial to make therapeutic plans for reducing complications from dysphagia.