Aspiration Following Stroke

Abstract

The swallowing musculature is represented asymmetrically in both hemispheres. The association between anatomic location of stroke and the occurrence of aspiration re mains uncertain. We reviewed neurologic, neuroimaging, and videofluoroscopic swallowing stud ies (VSS) in 37 patients with unilateral and bilateral strokes. The hemispheric site, side, and size of the lesion were determined by reviewing each patient's magnetic res onance imaging (MRI) and computerized tomographic (CT) scans. Presence of aspi ration was determined from VSS. All data were tabulated and analyzed based on the presence or absence of aspiration. Twenty patients (54 percent) had aspiration and 50 percent of those with as piration had an impaired cough reflex. The impaired cough reflex was significantly associated with aspiration (p < 0.01). A multivariate analysis looking at all variables of lesion side, size, and location showed that the probability of developing aspiration was higher in patients with left cerebral lesions (p < 0.06). Key Words: Swallowing disorder—Deglutition—MRI/CT—Videofluoroscopy.