Detecção de disfagia na fase aguda do acidente vascular cerebral isquêmico. Proposição de conduta baseada na caracterização dos fatores de risco

Disfagia e acidente vascular cerebral: relação entre o grau de severidade e o nível de comprometimento neurológico

“…Mainly, impairment in varying degrees in the oral and pharyngeal phases of swallowing are verified (4) . The present study had the aim to conduct clinical assessments because this is the only possibility for assessment available, besides being able to attribute a quick response and better knowledge regarding the patient's functional swallowing ability.…”

“…Recent studies on incidence and mortality revealed that, on average, someone in the United States has a stroke every 40 seconds; and at every four minutes someone dies of a stroke (3) . The cerebral circulation is mainly supplied by two major vascular systems: carotid system, responsible for supplying blood to the anterior three-quarters of the cerebral hemispheres by the anterior and middle cerebral arteries and anterior choroidal artery; and vertebrobasilar system, responsible for the vascularization of the brain stem, cerebellum and posterior portion of the cerebral hemispheres by the posterior cerebral artery (4,5) . The localization of the vascular accident, as well as its extension, have a direct relation to the clinical manifestations and the prognosis (4) .…”

“…The cerebral circulation is mainly supplied by two major vascular systems: carotid system, responsible for supplying blood to the anterior three-quarters of the cerebral hemispheres by the anterior and middle cerebral arteries and anterior choroidal artery; and vertebrobasilar system, responsible for the vascularization of the brain stem, cerebellum and posterior portion of the cerebral hemispheres by the posterior cerebral artery (4,5) . The localization of the vascular accident, as well as its extension, have a direct relation to the clinical manifestations and the prognosis (4) . The clinical manifestations described include severe headaches accompanied by vomiting and dizziness; hemiplegia; hemianopsia; speech and language disorders, such as aphasia, dysarthria and scanning speech; apraxia; postural and gait disorders; motor and sensory disorders, or isolated impairment of cranial nerves.…”

“…Complications such as pulmonary aspiration and pneumonia, hemiparesis, depression, emotional lability, and dysphagia, are possible consequences of stroke (6) . Dysphagia is a symptom that consists of difficulty to swallow (4) , and may be considered morbidity when expressed as a result of stroke, depending on the lesion type and the patient's age (7) . Cough, throat clearing, nasal regurgitation, weight loss, residue in the oral cavity, and nasal voice are the most common signs or indications of dysphagia (4) .…”

“…Dysphagia is a symptom that consists of difficulty to swallow (4) , and may be considered morbidity when expressed as a result of stroke, depending on the lesion type and the patient's age (7) . Cough, throat clearing, nasal regurgitation, weight loss, residue in the oral cavity, and nasal voice are the most common signs or indications of dysphagia (4) . The incidence of dysphagia after stroke can vary from 42% to 67% (7,8) and its presence is associated with an increased risk of pulmonary aspiration, malnutrition, dehydration, longer length of hospital stay, and death (7,9) .…”