Neurogenic Dysphagia in Subdural Hematoma

Area of Science:

• Neuroscience
• Clinical Medicine
• Surgical Innovation

Background:

• Dysphagia is a severe complication of traumatic brain injury (TBI), impacting up to 78% of patients.
• Subdural hematoma (SDH) is a common TBI subtype, yet dysphagia prevalence in SDH patients remains understudied.
• Dysphagia in TBI is associated with increased morbidity and mortality.

Purpose of the Study:

• To investigate the occurrence and predictors of dysphagia in patients with subdural hematoma (SDH).
• To evaluate the impact of dysphagia on functional outcomes in SDH patients.
• To assess the effectiveness of speech and language pathologist (SLP) treatment and surgical intervention for dysphagia in SDH.

Main Methods:

• Retrospective analysis of 545 SDH patients admitted between 2007 and 2020.
• Clinical swallowing assessments by SLPs for patients with suspected dysphagia.
• Severity rated by swallowing disorder scale; functional outcome by Glasgow Outcome Scale (GOS).

Main Results:

• Dysphagia was identified in 13% of SDH patients (71/545).
• Lower dysphagia prevalence observed in surgically treated patients (11.8%) versus conservative management (21.8%).
• Predictors included low GCS, cardiovascular disease, pneumonia; surgery was protective. Right-sided SDH was an additional predictor. Dysphagia correlated with worse functional outcomes (GOS 1-3).

Conclusions:

• Dysphagia is a frequent complication of SDH, significantly impacting functional outcomes.
• Early dysphagia identification and SLP intervention are critical for improving patient outcomes.
• Surgical intervention for SDH may serve as a protective factor against dysphagia, particularly in high-risk individuals.