Lesion location predicts transient and extended risk of aspiration after supratentorial ischemic stroke

Galovic, Marian; Leisi, Natascha; Müller, Marlise; Weber, Johannes; Abela, Eugenio; Kägi, Georg; Weder, Bruno J. (2013). Lesion location predicts transient and extended risk of aspiration after supratentorial ischemic stroke. Stroke, 44(10), pp. 2760-2767. Lippincott Williams & Wilkins 10.1161/STROKEAHA.113.001690

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BACKGROUND AND PURPOSE To assess the association of lesion location and risk of aspiration and to establish predictors of transient versus extended risk of aspiration after supratentorial ischemic stroke. METHODS Atlas-based localization analysis was performed in consecutive patients with MRI-proven first-time acute supratentorial ischemic stroke. Standardized swallowing assessment was carried out within 8±18 hours and 7.8±1.2 days after admission. RESULTS In a prospective, longitudinal analysis, 34 of 94 patients (36%) were classified as having acute risk of aspiration, which was extended (≥7 days) or transient (<7 days) in 17 cases. There were no between-group differences in age, sex, cause of stroke, risk factors, prestroke disability, lesion side, or the degree of age-related white-matter changes. Correcting for stroke volume and National Institutes of Health Stroke Scale with a multiple logistic regression model, significant adjusted odds ratios in favor of acute risk of aspiration were demonstrated for the internal capsule (adjusted odds ratio, 6.2; P<0.002) and the insular cortex (adjusted odds ratio, 4.8; P<0.003). In a multivariate model of extended versus transient risk of aspiration, combined lesions of the frontal operculum and insular cortex was the only significant independent predictor of poor recovery (adjusted odds ratio, 33.8; P<0.008). CONCLUSIONS Lesions of the insular cortex and the internal capsule are significantly associated with acute risk of aspiration after stroke. Combined ischemic infarctions of the frontal operculum and the insular cortex are likely to cause extended risk of aspiration in stroke patients, whereas risk of aspiration tends to be transient in subcortical stroke.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Abela, Eugenio and Weder, Bruno J.

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0039-2499

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

23 Jan 2015 15:36

Last Modified:

29 Oct 2015 11:44

Publisher DOI:

10.1161/STROKEAHA.113.001690

PubMed ID:

23887840

Uncontrolled Keywords:

deglutition disorders, magnetic resonance imaging, stroke

BORIS DOI:

10.7892/boris.61841

URI:

https://boris.unibe.ch/id/eprint/61841

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