The Ewha Medical Journal  2012;35(2):135-139

doi:10.12771/emj.2012.35.2.135

Long Term Improvement of Dysphagia in Lateral Medullary Infarction: A Case Report.

Jung Joong YOON 1 ; Soo Jeong HAN ; Sung Kyun HWANG ; Hye Kyung JUNG

Affiliations

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Keywords

Medullary infarction; Swallowing difficulty; Video fluoroscopic swallowing study

Country

Republic of Korea

Language

English

Abstract

This report concerns a male patient suffered from refractory dysphagia after subarachnoid hemorrhage. A 49-year-old man admitted with severe headache followed by mental change. Imaging studies revealed that subarachnoid hemorrhage was located in basal cistern, and demonstrated ruptured vertebral dissecting aneurysm. After operation, the patient recovered well except severe dysphagia. Initial VFSS showed aspiration in fluid trial, penetration in semisolid bolus, and large amount of pharyngeal residue with poor relaxation of upper esophageal sphincter. For about 5 months, his symptom and several follow-up VFSS findings did not show marked improvement by various treatments. On magnetic resonance imaging for further evaluation of his brain lesion, an old infarction in right lateral side of medulla was found. He kept dysphagia rehabilitation more than one year, and his symptom improved to the level of oral feeding at last.