[Evaluation and treatment of dysphagia in patients with cerebrovascular lesions and cranial injuries].

This study was designed to evaluate swallowing disorders and their evolution after rehabilitation treatment in a group of pts with cerebrovascular accident (CVA) localized in the brainstem (8 pts), cerebral hemisphere (8 pts) and in a group of pts with cranial trauma (8 pts). The diagnosis of swallowing disorders was based on videofluorography (VFG); rehabilitation treatment on Logemann's technique. All pts exhibited a variety of disturbances usually occurring in combination rather than as isolated disorders. The most frequent problem was a delayed swallowing reflex which was found in all pts of the three groups. This fact may reflect the importance of cortical as well as brainstem input to the triggering of the swallowing reflex. Nevertheless some important differences appeared in the groups: the great majority of cranial trauma pts exhibited a severe reduced tongue control while a reduced laryngeal closure was present only in brainstem CVA pts. The rehabilitation treatment determined a complete recovery of swallowing in 6/24 pts (25%) and seems to present a significant improvement, but not complete recovery of initial swallowing deficit in almost the remaining pts.