Successful treatment of pulmonary aspiration due to brain stem infarction by using cough exercise based on swallowing scintigraphy: preliminary observations.

Although dysphagia in stroke may result in lethal chest infection, it can be prevented by coughing. We report on a patient with dysphagia and aspiration who regained oral ingestion by swallowing with voluntary cough. A 54-year-old man with subarachnoidal hemorrhage underwent endovascular coiling and developed brain stem infarction. Scintigraphy showed pulmonary aspiration just after swallowing, but no radioactivity was detected in the lungs 10 min after swallowing with voluntary cough. Swallowing exercise with voluntary cough resulted in a safe swallow without enteral feeding. Even if laryngeal penetration and pulmonary aspiration are observed, chest infection could be prevented by swallowing exercise combined with voluntary cough.