Association of silent cerebral infarction with cerebral hemispheric--sub-tentorial infarction in patients with supra-nuclear dysarthria or dysphagia]

Little information is available concerning the latent effects of silent cerebral infarction (SCI) on dysarthria (DA), dysphagia (DP), or both. A detailed analysis of MR images of multiple cerebral infarction was carried out to determine whether SCI is associated with the development of DA or DP. In this study MR images of the supra- and sub-tentorial regions were obtained from 14 patients presenting with persistent DA and DP (DA + DP group) and 9 patients presenting with DA alone (DA group) after the first episode of cerebral infarction. The DA + DP inducing lesion was identified from the change in signal intensity and the side with symptoms in 6 patients. Involvement of 3 lesions of the bilateral cortical branches, striatum, and pons on the line connecting the contra-lateral SCI with the lesion were noted in 4 patients (67%, vs. 40% for the DA group). Latent association of SCI with the development of supra-nuclear DA and DP was noted in 1 patient each from the DA + DP and DA groups. The results of this study support the concept that SCI patients include those in which SCI is involved in the development of supra-nuclear DA or DP, and suggest that SCI should be treated.