![]() Follow-up interviews showed that 88% of the 27 patients who were contacted had resumed full oral intake 4 mo after the onset of stroke. There was a correlation between the detection of aspiration by modified barium meal videofluoroscopy and the development of aspiration pneumonia. The incidence of aspiration pneumonia was 11%. Statistical analyses revealed a significant association between poor outcome and disease involving the medulla, the presence of a wet voice during the initial swallowing test, and a delay or absence of the swallowing reflex. A total of 79% of the dysphagic individuals depended on tube feeding at the initial evaluation 22% of all individuals could not resume oral intake at discharge. ![]() Follow-up interviews were conducted via telephone to learn the general medical condition and feeding status of the patients 7-43 mo after hospital discharge.Ī total of 81% of the patients had dysphagia at the time of initial clinical swallowing evaluation, which was performed 10-75 days after the onset of stroke. Information on the patients' clinical features, feeding status, and the results of clinical and videofluoroscopic swallowing examinations were obtained through chart review. We retrospectively reviewed the medical records of 36 patients who were admitted because of brainstem stroke. ![]() doi:10.1111/j. study was conducted to delineate the incidence and outcome of dysphagia among hospitalized patients who were referred for rehabilitation because of brainstem stroke. The rule of 4 of the brainstem: a simplified method for understanding brainstem anatomy and brainstem vascular syndromes for the non-neurologist. Adams and Victor's principles of neurology 10th ed. Brainstem stroke: anatomy, clinical and radiological findings. Ortiz de Mendivil A, Alcalá-Galiano A, Ochoa M et-al. Read it at Google Books - Find it at Amazon Classical crossed brain stem syndromes: myth or reality?. Vernet syndrome (often not caused by a brainstem lesion).medial medullary syndrome (Dejerine syndrome).lateral medullary syndrome (Wallenberg syndrome).hemimedullary syndrome (Reinhold syndrome).lateral pontine syndrome (Marie-Foix syndrome).inferior medial pontine syndrome (Foville syndrome).Classificationīrainstem stroke syndromes are most commonly classified anatomically. These syndromes are classically caused by ischemic strokes that occur secondary to occlusion of small perforating arteries of the posterior circulation, however many have also been described secondary to hemorrhage, neoplasm, and demyelination 1-5. The rule of 4 of the brainstem is a useful and simple clinical tool to aid in the anatomical localization of signs and symptoms in a brainstem stroke 6. Clinical presentationĮach brainstem stroke syndrome has a characteristic clinical picture according to the involved area, however, generally, there is ipsilateral cranial nerve palsy and contralateral hemiplegia/hemiparesis and/or hemisensory loss 1-5. The most common brainstem stroke syndrome seems to be the lateral medullary syndrome (Wallenberg syndrome) 1. Although many different brainstem stroke syndromes have been classically described, the majority appear extremely rarely in the literature and are mainly for historical interest only 1.
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