Causes of Dysphagia after Stroke

Written by Sheng Wang
Neurology
Updated on November 25, 2024
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The causes of dysphagia resulting from a stroke are largely related to the location of the stroke. Dysphagia mainly involves the glossopharyngeal and vagus nerves, which are distributed in the medulla oblongata of the brainstem. Therefore, if you have a brainstem stroke, specifically at the medulla oblongata, there is a significant chance of experiencing coughing due to aspiration and dysphagia. If the stroke occurs in a different area, these symptoms are unlikely to appear. A stroke in the cerebral hemisphere, since it has bilateral nerve supply, does not lead to noticeable coughing if only one side is affected. However, if one side is affected this year and the other side next year, similar symptoms of aspiration cough and dysphagia will occur. Therefore, neurologically, the location and specific site of the stroke are crucial, as each location presents different symptoms.

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Written by Tang Bo
Neurology
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What are the symptoms of a stroke?

Stroke, also commonly referred to as cerebrovascular accident, is caused by the rupture or blockage of blood vessels within the skull, leading to necrosis of brain tissue and a series of symptoms. It is divided into ischemic stroke and hemorrhagic stroke. Ischemic stroke, commonly known as cerebral infarction or stroke, while hemorrhagic stroke refers to cerebral hemorrhage. Generally, ischemic strokes account for 80% of cases. Ischemic stroke is caused by blockage of blood vessels leading to necrosis of brain tissue, presenting with a series of symptoms such as hemiplegic numbness. Cerebral hemorrhage results from rupture of brain blood vessels causing damage to brain cells and symptoms of compression, and may also present with symptoms such as hemiplegic numbness. Both types can be differentiated by their symptoms, and can also be definitively diagnosed through a CT scan.

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Written by Zhang Hui
Neurology
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What does a stroke cause?

Stroke primarily causes neurological deficits such as limb paralysis in patients. This paralysis is typically hemiplegic, where one side of the body lacks strength, the affected limbs cannot walk, and the upper limbs cannot be lifted. Stroke can also cause numbness in the limbs. Patients may experience reduced pain and temperature sensation on one side of the body, unable to feel pain or temperature. Additionally, stroke can lead to headaches and symptoms such as nausea and vomiting, commonly seen in hemorrhagic strokes, such as cerebral hemorrhage. Furthermore, strokes in specific brain areas like the frontal lobe, temporal lobe, and hippocampus can cause cognitive impairments. Patients become slow to react, have significantly reduced learning and memory capabilities, and their ability to perform daily activities and work is noticeably affected. Strokes can also cause unclear speech, where patients have difficulties in expressing themselves verbally and may even be unable to understand conversations.

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Neurology
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Can a stroke be cured?

Stroke can result in sequelae such as deviation of the mouth, slurred speech, hemiplegia, numbness of extremities, coughing when drinking water, hoarseness, and difficulty swallowing. If the stroke affects a smaller area or is not located in a critical area, recovery tends to be better. However, if the infarct is large or occurs in a critical area like the brainstem, sequelae may persist, with partial function recovery possible within about three to six months.

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Key Points in the Treatment of Different Recovery Stages of Stroke

Stroke includes ischemic stroke and hemorrhagic stroke, namely cerebral infarction and cerebral hemorrhage. Their treatments are generally opposite. If it is a cerebral infarction, thrombolytic therapy is needed within 4.5 hours of the acute phase. It is necessary to consider whether there are indications and contraindications, and whether the patient and family members agree to undergo thrombolytic therapy. Regardless of whether thrombolytic therapy is administered, it is essential to subsequently check the condition of the cranial vessels to determine if surgical treatment is needed. If surgery is not required, hospitalization for conservative treatment might be necessary. Typically, about 7 to 14 days after the acute phase, rehabilitation treatment may be needed once the patient's condition stabilizes. The duration of rehabilitation treatment usually depends on the patient's recovery progress. Afterwards, it is important to consider the patient's underlying diseases, such as hypertension, diabetes, and other risk factors, to perform secondary prevention, which involves medication and control of risk factors. In the case of cerebral hemorrhage, the treatment during the acute phase depends on the amount and location of the bleeding and whether there are indications for surgery to determine if surgical treatment is necessary. If conservative treatment is chosen, it also involves hospital treatment, followed by possible rehabilitation treatment once stabilized.

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What does "brain stroke dnt" mean?

The term "DNT" refers to the time from when an acute stroke patient arrives at the hospital to the start of intravenous thrombolytic treatment. Both domestic and international guidelines recommend the DNT to be within 60 minutes—the earlier, the better. This standard was established by the National Health and Family Planning Commission. The time it takes for pre-hospital emergency care and in-hospital medication administration is approximately 60 minutes each. It is only by improving the time from pre-hospital treatment to medication administration within this golden window that we can enhance the patient's survival rate, prognosis, and quality of life, while minimizing disability rates.