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Cerebral Microbleeds are Associated With Post-stroke Dysphagia in Spontaneous Intracerebral Hemorrhage Patients

Shu-Mei Yang1, Yen-Heng Lin2, Ting-Ju Lai3

  • 1Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan.

World Neurosurgery
|September 14, 2025
PubMed
Abstract

Insights

Cerebral microbleeds (CMBs) predict longer recovery from post-stroke dysphagia (PSD) in intracerebral hemorrhage (ICH) patients. Identifying CMBs early can personalize swallowing rehabilitation after ICH.

Area of Science:

  • Neurology
  • Radiology
  • Gastroenterology

Background:

  • Cerebral microbleeds (CMBs) are indicators of small vessel disease and can affect outcomes in patients with intracerebral hemorrhage (ICH).
  • Post-stroke dysphagia (PSD) is a common and significant complication following ICH, impacting patient recovery and quality of life.

Purpose of the Study:

  • To investigate the association between the presence of lobar cerebral microbleeds (CMBs) and the development and severity of post-stroke dysphagia (PSD) in patients who have experienced a spontaneous intracerebral hemorrhage (ICH).

Main Methods:

  • A retrospective cohort study involving 187 patients with acute spontaneous ICH who underwent MRI for lobar CMB assessment.
  • Lobar CMBs were identified using susceptibility-weighted MRI by a neuroradiologist.
  • PSD was evaluated through nasogastric (NG) tube retention and the Functional Oral Intake Scale (FOIS) at 1, 4, and 12 weeks post-ICH.

Main Results:

  • 61.5% of ICH patients presented with lobar CMBs.
  • Patients with lobar CMBs had significantly higher rates of NG tube retention at 4 and 12 weeks post-ICH compared to those without CMBs.
  • ICH patients with lobar CMBs exhibited significantly lower FOIS scores at 4 weeks, indicating poorer oral intake.

Conclusions:

  • Lobar CMBs are significantly associated with prolonged post-stroke dysphagia in patients with spontaneous ICH.
  • Cerebral microbleeds may serve as valuable predictive markers for dysphagia outcomes after ICH.
  • Early detection of CMBs can inform personalized rehabilitation strategies to enhance swallowing recovery in ICH patients.
Keywords:
Cerebral microbleedsDysphagiaIntracerebral hemorrhageNasogastric tube

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