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Open Access 01-10-2021 | Stroke | Original Article

Ischemic Lesion Location Based on the ASPECT Score for Risk Assessment of Neurogenic Dysphagia

Authors: Sriramya Lapa, Christian Foerch, Oliver C. Singer, Elke Hattingen, Sebastian Luger

Published in: Dysphagia | Issue 5/2021

Abstract

Dysphagia is common in patients with middle cerebral artery (MCA) infarctions and associated with malnutrition, pneumonia, and mortality. Besides bedside screening tools, brain imaging findings may help to timely identify patients with swallowing disorders. We investigated whether the Alberta stroke program early CT score (ASPECTS) allows for the correlation of distinct ischemic lesion patterns with dysphagia. We prospectively examined 113 consecutive patients with acute MCA infarctions. Fiberoptic endoscopic evaluation of swallowing (FEES) was performed within 24 h after admission for validation of dysphagia. Brain imaging (CT or MRI) was rated for ischemic changes according to the ASPECT score. 62 patients (54.9%) had FEES-proven dysphagia. In left hemispheric strokes, the strongest associations between the ASPECTS sectors and dysphagia were found for the lentiform nucleus (odds ratio 0.113 [CI 0.028–0.433; p = 0.001), the insula (0.275 [0.102–0.742]; p = 0.011), and the frontal operculum (0.280 [CI 0.094–0.834]; p = 0.022). A combination of two or even all three of these sectors together increased relative dysphagia frequency up to 100%. For right hemispheric strokes, only non-significant associations were found which were strongest for the insula region. The distribution of early ischemic changes in the MCA territory according to ASPECTS may be used as risk indicator of neurogenic dysphagia in MCA infarction, particularly when the left hemisphere is affected. However, due to the exploratory nature of this research, external validation studies of these findings are warranted in future.

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Title: Ischemic Lesion Location Based on the ASPECT Score for Risk Assessment of Neurogenic Dysphagia
Authors: Sriramya Lapa
Christian Foerch
Oliver C. Singer
Elke Hattingen
Sebastian Luger
Publication date: 01-10-2021
Publisher: Springer US
Keywords: Stroke
Pneumonia
Dysphagia
Dysphagia
Dysphagia
Published in: Dysphagia / Issue 5/2021
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI: https://doi.org/10.1007/s00455-020-10204-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Ischemic Lesion Location Based on the ASPECT Score for Risk Assessment of Neurogenic Dysphagia

Abstract

At a glance: The ONWARDS insulin icodec trials

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Abstract

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