ASPIRATION IN ACUTE STROKE - A CLINICAL-STUDY WITH VIDEOFLUOROSCOPY

To assess the incidence of lung aspiration in acute stroke, and attemp t to identify factors which render such patients at risk of aspiration , consecutive patients admitted to hospital within 24 h of their first symptomatic stroke were studied prospectively. Sixty patients who wer e conscious, and who did not have any preceding neurological or other cause of dysphagia, were assessed clinically and underwent a bedside w ater-swallowing test and videofluoroscopy within 72 h of stroke. Twent y-five patients (42%) were seen to aspirate at videofluoroscopy; of th ese 20% did not have overt dysphagia as detected by a simple water-swa llowing test. Factors found to be significantly associated with aspira tion were reduced pharyngeal sensation, dysphagia and stroke severity. Aspiration is common in the early period following acute stroke; diso rdered pharyngeal sensation is an important concomitant of this and sh ould be carefully tested in each patient admitted with acute stroke.