Abstract
Background
The study was performed to identify the association between total magnetic resonance imaging burden of small vessel disease and occurrence of post-stroke dysphagia in patients with a single recent small subcortical infarct.
Methods
All patients with a magnetic resonance imaging-confirmed single recent small subcortical infarct underwent the water-swallowing test and volume-viscosity swallow test within the first 24 hours following admission to assess swallowing. Demographic and clinical data were extracted from our stroke database. Based on brain magnetic resonance imaging, we independently rated the presence of cerebral microbleeds, lacunes, white matter hyperintensities and enlarged perivascular spaces. The presence of each small vessel disease feature was summed in the total small vessel disease burden, ranging from 0–4.
Results
In total, 308 patients with a single recent small subcortical infarct were enrolled. Overall, 54 (17.5%) were diagnosed with post-stroke dysphagia. The risk factors related to post-stroke dysphagia included the following: older age, National Institute of Health Stroke Scale, higher C-reactive protein levels and higher fibrinogen levels. Based on multiple logistic regression, two variables with the most significant associations, namely, National Institute of Health Stroke Scale and total small vessel disease burden, were combined with age, gender, history of hypertension, C-reactive protein level and fibrinogen level.
Conclusions
Dysphagia in patients with a single recent small subcortical infarct resulted from severe small vascular disease, which was associated with systemic inflammation. This information might provide a new anti-inflammatory treatment for post-stroke dysphagia in the future.