{"title":"自发性脑出血患者脑微出血与脑卒中后吞咽困难相关","authors":"Shu-Mei Yang, Yen-Heng Lin, Ting-Ju Lai, Ya-Chu Hsu, You-Lin Lu, Chueh-Hung Wu, Tyng-Guey Wang, Meng-Ting Lin","doi":"10.1016/j.wneu.2025.124465","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Cerebral microbleeds (CMBs) are markers of small vessel disease in patients with intracerebral hemorrhage (ICH) and may impact recovery. Post-stroke dysphagia (PSD) is a significant complication of ICH. This study investigates the association between CMBs and PSD in patients with spontaneous ICH.</p><p><strong>Methods: </strong>This retrospective cohort study included patients with acute spontaneous ICH who underwent magnetic resonance imaging (MRI) for lobar CMB assessment between June 2019 and June 2023. Lobar CMBs were defined based on susceptibility-weighted MRI interpreted by a board-certificated neuroradiologist. PSD was assessed with nasogastric (NG) tube retention and Functional Oral Intake Scale (FOIS) levels at the 1<sup>st</sup>, 4<sup>th</sup>, and 12<sup>th</sup> week after ICH. Logistic regression was performed to evaluate the association between lobar CMBs and PSD.</p><p><strong>Results: </strong>A total of 187 patients were included, of whom 61.5% presented with lobar CMBs. The NG tube retention rate was significantly higher in ICH patients with lobar CMB compared to those without at 4 (47.8% vs. 22.2%, p = 0.0004) and 12 weeks (42.6% vs. 9.7%, p < 0.0001). FOIS levels were significantly lower in ICH patients with lobar CMBs at 4 weeks (5.0 vs. 5.7, p = 0.0449). ICH patients with lobar CMBs showed a significant association with prolonged NG tube retention at 4 and 12 weeks.</p><p><strong>Conclusions: </strong>Lobar CMBs were associated with prolonged PSD in patients with spontaneous ICH. CMBs may serve as predictive markers for post-ICH dysphagia outcomes. Early identification of CMBs may aid in personalizing rehabilitation strategies to improve swallowing recovery in ICH patients.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124465"},"PeriodicalIF":2.1000,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cerebral Microbleeds are Associated with Post-Stroke Dysphagia in Spontaneous Intracerebral Hemorrhage Patients.\",\"authors\":\"Shu-Mei Yang, Yen-Heng Lin, Ting-Ju Lai, Ya-Chu Hsu, You-Lin Lu, Chueh-Hung Wu, Tyng-Guey Wang, Meng-Ting Lin\",\"doi\":\"10.1016/j.wneu.2025.124465\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Cerebral microbleeds (CMBs) are markers of small vessel disease in patients with intracerebral hemorrhage (ICH) and may impact recovery. Post-stroke dysphagia (PSD) is a significant complication of ICH. This study investigates the association between CMBs and PSD in patients with spontaneous ICH.</p><p><strong>Methods: </strong>This retrospective cohort study included patients with acute spontaneous ICH who underwent magnetic resonance imaging (MRI) for lobar CMB assessment between June 2019 and June 2023. Lobar CMBs were defined based on susceptibility-weighted MRI interpreted by a board-certificated neuroradiologist. PSD was assessed with nasogastric (NG) tube retention and Functional Oral Intake Scale (FOIS) levels at the 1<sup>st</sup>, 4<sup>th</sup>, and 12<sup>th</sup> week after ICH. Logistic regression was performed to evaluate the association between lobar CMBs and PSD.</p><p><strong>Results: </strong>A total of 187 patients were included, of whom 61.5% presented with lobar CMBs. The NG tube retention rate was significantly higher in ICH patients with lobar CMB compared to those without at 4 (47.8% vs. 22.2%, p = 0.0004) and 12 weeks (42.6% vs. 9.7%, p < 0.0001). FOIS levels were significantly lower in ICH patients with lobar CMBs at 4 weeks (5.0 vs. 5.7, p = 0.0449). ICH patients with lobar CMBs showed a significant association with prolonged NG tube retention at 4 and 12 weeks.</p><p><strong>Conclusions: </strong>Lobar CMBs were associated with prolonged PSD in patients with spontaneous ICH. CMBs may serve as predictive markers for post-ICH dysphagia outcomes. Early identification of CMBs may aid in personalizing rehabilitation strategies to improve swallowing recovery in ICH patients.</p>\",\"PeriodicalId\":23906,\"journal\":{\"name\":\"World neurosurgery\",\"volume\":\" \",\"pages\":\"124465\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-09-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World neurosurgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.wneu.2025.124465\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.wneu.2025.124465","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：脑微出血（CMBs）是脑出血（ICH）患者小血管病变的标志，可能影响患者的康复。脑卒中后吞咽困难（PSD）是脑出血的重要并发症。本研究探讨自发性脑出血患者CMBs与PSD之间的关系。方法：本回顾性队列研究纳入了2019年6月至2023年6月期间接受磁共振成像（MRI）评估脑叶CMB的急性自发性脑出血患者。大叶CMBs的定义是基于由委员会认证的神经放射学家解释的敏感性加权MRI。在脑出血后第1周、第4周和第12周，采用鼻胃管留置和功能性口服摄入量表（FOIS）水平评估PSD。采用Logistic回归来评估大叶CMBs与PSD之间的关系。结果：共纳入187例患者，其中61.5%为大叶性CMBs。合并大叶性CMB的脑出血患者在第4周（47.8% vs. 22.2%, p = 0.0004）和第12周（42.6% vs. 9.7%, p < 0.0001）时，NG管保留率显著高于未合并CMB的脑出血患者。脑出血合并大叶性CMBs患者的FOIS水平在4周时显著降低（5.0 vs. 5.7, p = 0.0449）。脑出血合并大叶性CMBs的患者在4周和12周时与NG管潴留时间延长有显著相关性。结论：脑叶CMBs与自发性脑出血患者的PSD延长有关。CMBs可作为脑出血后吞咽困难结局的预测指标。早期识别CMBs可能有助于个性化康复策略，以改善脑出血患者的吞咽恢复。
Cerebral Microbleeds are Associated with Post-Stroke Dysphagia in Spontaneous Intracerebral Hemorrhage Patients.
Objective: Cerebral microbleeds (CMBs) are markers of small vessel disease in patients with intracerebral hemorrhage (ICH) and may impact recovery. Post-stroke dysphagia (PSD) is a significant complication of ICH. This study investigates the association between CMBs and PSD in patients with spontaneous ICH.
Methods: This retrospective cohort study included patients with acute spontaneous ICH who underwent magnetic resonance imaging (MRI) for lobar CMB assessment between June 2019 and June 2023. Lobar CMBs were defined based on susceptibility-weighted MRI interpreted by a board-certificated neuroradiologist. PSD was assessed with nasogastric (NG) tube retention and Functional Oral Intake Scale (FOIS) levels at the 1st, 4th, and 12th week after ICH. Logistic regression was performed to evaluate the association between lobar CMBs and PSD.
Results: A total of 187 patients were included, of whom 61.5% presented with lobar CMBs. The NG tube retention rate was significantly higher in ICH patients with lobar CMB compared to those without at 4 (47.8% vs. 22.2%, p = 0.0004) and 12 weeks (42.6% vs. 9.7%, p < 0.0001). FOIS levels were significantly lower in ICH patients with lobar CMBs at 4 weeks (5.0 vs. 5.7, p = 0.0449). ICH patients with lobar CMBs showed a significant association with prolonged NG tube retention at 4 and 12 weeks.
Conclusions: Lobar CMBs were associated with prolonged PSD in patients with spontaneous ICH. CMBs may serve as predictive markers for post-ICH dysphagia outcomes. Early identification of CMBs may aid in personalizing rehabilitation strategies to improve swallowing recovery in ICH patients.
期刊介绍：
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS
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