Evaluation of neurogenic dysphagia in Iraqi patients with acute stroke

Objectives: To clinically assess neurogenic dysphagia,and to correlate its presence with demographic features, different stroke risk factors, anatomical arterial territorial stroke types, and pathological stroketypes.Methods: Seventy-two stroke inpatients were studied between July 2007 and February 2008, at the Departments of Medicine and Neurology at Al-Yarmouk Teaching Hospital, Baghdad, and RizgaryTeaching Hospital, Erbil, Iraq. All patients were assessed using the Mann Assessment of Swallowing Ability score (MASA), Modified Rankin Scale, and the Stroke Risk Scorecard. All patients were reassessed after one month.Results: There were 40 males and 32 females. Sixtyeight patients had ischemic stroke, and 4 had primaryintracerebral hemorrhage (ICH). According to the MASA score, 55% of anterior circulation stroke(ACS) cases were associated with dysphasia, and 91%of lateral medullary syndrome cases were associated with dysphagia. Fifty-six percent of ACS dysphagic cases improved within the first month. Forty percent of dysphagic patients died in the one month follow upperiod, and in most, death was caused by aspiration pneumonia. We observed no significant differences regarding demographic features of dysphagia.Conclusion: Dysphagia can be an indicator of theseverity of stroke causing higher mortality andmorbidity in affected patients. It was not related to the stroke risk factors and the type of stroke. It is essential from a prognostic point of view to assess swallowing,and to treat its complications early.