Relationship between the Injury Location and Swallowing Difficulty among Stroke Patients, A Retrospective Cohort Study


  • Rawan Azzam Hamad Medical Corporation, Doha, Qatar
  • Dina Emam Hamad Medical Corporation, Doha, Qatar
  • Mamoun Nor Eldein Hamad Medical Corporation, Doha, Qatar
  • Olfa Al-Mannai Hamad Medical Corporation, Doha, Qatar



Stroke, Post-Stroke Dysphagia, Swallowing, Speech Therapy, Video Fluoroscopy


Post-stroke dysphagia (PSD), a neurological or mechanical disorder that hinders food transport from the oral cavity to the stomach. It has been widely associated with severe complications with higher mortality and morbidity rates. Traditional therapies for the treatment of dysphagia mainly focused on compensatory methods and behavioural rehabilitation approaches. The retrospective cohort study aimed to determine the association and correlation between developments of dysphagia in relation to the location of the stroke and to identify the swallowing recovery period following the stroke. A retrospective cohort study investigated swallowing difficulties in 64 stroke patients at an ambulatory care centre over a year. Data collection involved reviewing medical records and imaging reports, with analyses conducted using SPSS software, ANOVA and chi-square methods to assess associations between injury location and swallowing difficulty. Hemorrhagic stroke was more prevalent (65.6%) than ischemic stroke (34.4%). A significant association was found between gender and stroke type, with males exhibiting a higher prevalence of ischemic strokes (71.4%) compared to females (29.8%). Age differences between stroke types, gender and affected swallowing phases and stroke type and affected swallowing phase revealed no significant associations. Distinct differences were noted in swallowing difficulties across stroke types. Furthermore, recovery time varied depending on the intervention method, with speech therapy linked to shorter recovery periods. The study underscores the importance of considering gender and stroke-type-specific differences in stroke prevalence, age distribution, and swallowing difficulties. These findings contribute valuable insights to understanding stroke characteristics and their implications for clinical management and rehabilitation strategies.


Download data is not yet available.


Ahangar, A. A., Saadat, P., Heidari, B., Taheri, S. T., & Alijanpour, S. (2018). Sex difference in types and distribution of risk factors in ischemic and hemorrhagic stroke. International Journal of Stroke, 13(1), 83-86.

Cabib, C., Ortega, O., Kumru, H., Palomeras, E., Vilardell, N., Alvarez‐Berdugo, D., Muriana, D., Rofes, L., Terré, R., & Mearin, F. (2016). Neurorehabilitation strategies for poststroke oropharyngeal dysphagia: from compensation to the recovery of swallowing function. Annals of the New York Academy of Sciences, 1380(1), 121-138.

Caesar, L. G., & Kitila, M. (2020). Speech-language pathologists’ perceptions of their preparation and confidence for providing dysphagia services. Perspectives of the ASHA Special Interest Groups, 5(6), 1666-1682.

Carbo, A. I., Brown, M., & Nakrour, N. (2021). Fluoroscopic swallowing examination: radiologic findings and analysis of their causes and pathophysiologic mechanisms. Radiographics, 41(6), 1733-1749.

Carucci, L. R., & Turner, M. A. (2015). Dysphagia revisited: common and unusual causes. Radiographics, 35(1), 105-122.

Cheng, I., Takahashi, K., Miller, A., & Hamdy, S. (2022). Cerebral control of swallowing: an update on neurobehavioral evidence. Journal of the Neurological Sciences, 442, 120434.

Choy, J., Pourkazemi, F., Bogaardt, H., Anderson, C., Chai, S. Y., & Pebdani, R. N. (2024). Factors influencing speech pathology practice in dysphagia after stroke: A qualitative focus group study. International Journal of Language & Communication Disorders.

Cohen, D. L., Roffe, C., Beavan, J., Blackett, B., Fairfield, C. A., Hamdy, S., Havard, D., McFarlane, M., McLauglin, C., & Randall, M. (2016). Post-stroke dysphagia: a review and design considerations for future trials. International Journal of Stroke, 11(4), 399-411.

Coleman, E. R., Moudgal, R., Lang, K., Hyacinth, H. I., Awosika, O. O., Kissela, B. M., & Feng, W. (2017). Early rehabilitation after stroke: a narrative review. Current atherosclerosis reports, 19, 1-12.

Daniels, S. K., Huckabee, M.-L., & Gozdzikowska, K. (2019). Dysphagia following stroke. Plural Publishing.

Dehkharghani, S., & Andre, J. (2017). Imaging approaches to stroke and neurovascular disease. Neurosurgery, 80(5), 681-700.

El Amki, M., & Wegener, S. (2017). Improving cerebral blood flow after arterial recanalization: a novel therapeutic strategy in stroke. International journal of molecular sciences, 18(12), 2669.

Fang, W.-j., Zheng, F., Zhang, L.-z., Wang, W.-h., Yu, C.-c., Shao, J., & Wu, Y.-j. (2022). Research progress of clinical intervention and nursing for patients with post-stroke dysphagia. Neurological Sciences, 43(10), 5875-5884.

Felix, C. C., Joseph, M. E., & Daniels, S. K. (2019). Clinical decision making in patients with stroke-related dysphagia. Seminars in Speech and Language, 40(3), 187-197.

Galera, P., Dulau‐Florea, A., & Calvo, K. R. (2019). Inherited thrombocytopenia and platelet disorders with germline predisposition to myeloid neoplasia. International Journal of Laboratory Hematology, 41, 131-141.

Goldstein, L. B. (2019). Epidemiology of cerebrovascular disease. In Vascular Medicine: A Companion to Braunwald’s Heart Disease (pp. 361). Amsterdam, The Netherlands: Elsevier.

González-Fernández, M., Brodsky, M. B., & Palmer, J. B. (2015). Poststroke communication disorders and dysphagia. Physical Medicine and Rehabilitation Clinics, 26(4), 657-670.

Heart Disease and Stroke Statistics Update Fact Sheet. (2024). American Heart Association, Inc.

Hu, X., De Silva, T. M., Chen, J., & Faraci, F. M. (2017). Cerebral vascular disease and neurovascular injury in ischemic stroke. Circulation research, 120(3), 449-471.

Iordanova, R., & Reddivari, A. K. R. (2019). Neuroanatomy, medulla oblongata. In StatPearls. Treasure Island, FL: StatPearls Publishing.

Jones, C. A., Colletti, C. M., & Ding, M.-C. (2020). Post-stroke dysphagia: recent insights and unanswered questions. Current neurology and neuroscience reports, 20, 1-12.

Jones, O., Cartwright, J., Whitworth, A., & Cocks, N. (2018). Dysphagia therapy post stroke: An exploration of the practices and clinical decision-making of speech-language pathologists in Australia. International Journal of Speech-Language Pathology, 20(2), 226-237.

Lindsay, L. R., Thompson, D. A., & O’Dell, M. W. (2020). Updated approach to stroke rehabilitation. Medical Clinics, 104(2), 199-211.

Lutski, M., Zucker, I., Shohat, T., & Tanne, D. (2017). Characteristics and outcomes of young patients with first-ever ischemic stroke compared to older patients: the National Acute Stroke ISraeli Registry. Frontiers in Neurology, 8, 283442.

Maeshima, A. O. a. S. (2019). Swallowing Disorders in Patients with Stroke.

Matsuo, K., & Palmer, J. B. (2016). Video fluoroscopic techniques for the study of oral food processing. Current opinion in food science, 9, 1-10.

Morseth, B., Geelhoed, B., Linneberg, A., Johansson, L., Kuulasmaa, K., Salomaa, V., Iacoviello, L., Costanzo, S., Söderberg, S., & Niiranen, T. J. (2021). Age-specific atrial fibrillation incidence, attributable risk factors and risk of stroke and mortality: results from the MORGAM Consortium. Open Heart, 8(2), e001624.

Murry, T., Carrau, R. L., & Chan, K. (2020). Clinical management of swallowing disorders. Plural Publishing.

Okeahialam, B. N., & Sirisena, A. I. (2023). The Physics of Stroke. Journal of Stroke Medicine, 6(1), 7-10.

Qiao, J., Wu, Z.-m., Ye, Q.-p., Dai, M., Dai, Y., He, Z.-t., & Dou, Z.-l. (2022). Characteristics of dysphagia among different lesion sites of stroke: A retrospective study. Frontiers in Neuroscience, 16, 944688.

Serra-Prat, M., Palomera, M., Gomez, C., Sar-Shalom, D., Saiz, A., Montoya, J. G., Navajas, M., Palomera, E., & Clavé, P. (2012). Oropharyngeal dysphagia as a risk factor for malnutrition and lower respiratory tract infection in independently living older persons: a population-based prospective study. Age and ageing, 41(3), 376-381.

Sheng, R., Chen, C., Chen, H., & Yu, P. (2023). Repetitive transcranial magnetic stimulation for stroke rehabilitation: insights into the molecular and cellular mechanisms of neuroinflammation. Frontiers in Immunology, 14, 1197422.

Shi, Y., Yang, D., Zeng, Y., & Wu, W. (2017). Risk factors for post-stroke depression: a meta-analysis. Frontiers in aging neuroscience, 9, 218.

Tanashyan, M., Berdnikovich, E., & Lagoda, O. (2018). Post-stroke dysphagia: Novel treatment approaches. Neurology, Neuropsychiatry, Psychosomatics, 10(2), 57-62.

Thiyagalingam, S., Kulinski, A. E., Thorsteinsdottir, B., Shindelar, K. L., & Takahashi, P. Y. (2021). Dysphagia in older adults. Mayo Clinic Proceedings, 96(5), 1245-1257.

Turra, G. S., Schwartz, I. V. D., Almeida, S. T. d., Martinez, C. C., Bridi, M., & Barreto, S. S. M. (2021). Efficacy of speech therapy in post-intubation patients with oropharyngeal dysphagia: A randomized controlled trial. CoDAS, 33(5), e20200215.

Wilmskoetter, J., Daniels, S. K., & Miller, A. J. (2020). Cortical and subcortical control of swallowing—can we use information from lesion locations to improve diagnosis and treatment for patients with stroke? American journal of speech-language pathology, 29(2S), 1030-1043.

Zameer, S., Siddiqui, A. S., & Riaz, R. (2021). Multimodality imaging in acute ischemic stroke. Current Medical Imaging, 17(5), 567-577.

Zhong, L., Rao, J., Wang, J., Li, F., Peng, Y., Liu, H., Zhang, Y., & Wang, P. (2021). Repetitive transcranial magnetic stimulation at different sites for dysphagia after stroke: a randomized, observer-blind clinical trial. Frontiers in Neurology, 12, 625683.




How to Cite

Azzam, R., Emam, D., Eldein, M. N., & Al-Mannai, O. (2024). Relationship between the Injury Location and Swallowing Difficulty among Stroke Patients, A Retrospective Cohort Study. American Journal of Medical Science and Innovation, 3(2), 1–11.