Association between Microbleeds Observed on T2-weighted Magnetic Resonance Images and Dysphagia in Patients with Acute Supratentorial Cerebral Hemorrhage

• Published in: Journal of stroke and cerebrovascular diseases 2014-10, Vol.23 (9), p.2458-2463
• Main Authors: Maeshima, Shinichiro, MD, PhD, Osawa, Aiko, MD, PhD, Yamane, Fumitaka, MD, PhD, Ishihara, Shoichiro, MD, PhD, Tanahashi, Norio, MD, PhD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Cardiovascular; Cerebral hemorrhage; Cerebral Hemorrhage - complications; Cerebral Hemorrhage - pathology; Cerebral Hemorrhage - psychology; cerebral microbleeds; Deglutition; Deglutition Disorders - etiology; Deglutition Disorders - pathology; Deglutition Disorders - psychology; dysphagia; Eating; Female; Hematoma - complications; Hematoma - pathology; Hematoma - psychology; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Neurology; Neuropsychological Tests; neuroradiology; rehabilitation; Risk Factors
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2014.05.029

Background Approximately one-half of all patients with acute intracerebral hemorrhage (ICH) develop dysphagia that can lead to pneumonia or fatal outcomes; however, there are no reports about the relationship between swallowing function and cerebral microbleeds (CMBs) in these patients. Therefore, we investigated whether CMBs were associated with dysphagia in patients with ICH. Methods A total of 100 patients (mean age, 65.1 ± 14.1 years; range, 36-95 years) with acute supratentorial ICH were included in this study. CMBs were detected on T2*-weighted magnetic resonance imaging performed during admission using a 1.5-T scanner (mean duration from onset to magnetic resonance imaging, 12.6 ± 8.4 days). We assessed swallowing function by using bedside swallowing assessments on admission and by monitoring the mode of nutritional intake at discharge in relation to the number and location of CMBs. Results CMBs were detected in 60 of the 100 patients (60%) and were related to dysphagia. The number of CMBs and dysphagia were not related, but a significant relationship was observed in the presence of bilateral hematomas and CMBs. Conclusions In addition to assessing just the presence or absence of CMBs, clinicians should identify the presence of bilateral or deep lesions in patients with ICH from the perspective of swallowing dysfunction.