| 소속 |
Department of Rehabilitation Medicine, College of Medicine, Chungnam National University, Daejeon, Republic of Korea1, Chungnam Regional Cardiocerebrovascular Center, Chungnam National University Hospital, Daejeon, Republic of Korea2 |
Introduction
The objective of this study was to investigate the relationship between rhinorrhea and Stroke in patients who had a stroke.
Subjects & Methods
This study was conducted through a retrospective review of medical records and questionnaires from outpatient stroke patients from June 2020 to July 2020. The inclusion criteria were adults over the age of 19, and stroke patients who were diagnosed through CT or MRI. Patients with existing neurologic diseases or medical conditions with a life expectancy of less than one year were excluded.
All subjects completed a questionnaire about the sino-nasal outcome test (SNOT-22), and the autonomic nervous system symptoms. The Korean version of the modified Barthel index (K-MBI), Korean mini-mental state examination (K-MMSE), functional ambulatory category (FAC), and modified Rankin scale (mRS) were performed on the subjects who visited the outpatient clinic. Through retrospective medical record review, demographic data, and clinical data including the Korean version of National Institute of Health Stroke Scale (K-NIHSSS), K-MBI, K-MMSE, FAC, and mRS on admission and at discharge were collected.
Result
A total of 60 stroke patients were enrolled. Fifteen of the subjects had new rhinorrhea symptoms after the onset of stroke (rhinorrhea group), and 45 had no rhinorrhea symptoms (no-rhinorrhea group). The mean age of the rhinorrhea group and the no-rhinorrhea group were 61.20±9.84 and 61.78±12.89, respectively. The mean initial clinical evaluations (K-NIHSSS, K-MBI, K-MMSE, FAC, and mRS) were not different significantly between the rhinorrhea group and the no-rhinorrhea group (Table 1). In the rhinorrhea group, 14 out of 15 subjects have clear rhinorrhea, and one subject filled out a questionnaire that he did not know. Eleven subjects answered that the rhinorrhea was thin and 4 had moderate viscosity. Regarding the period when rhinorrhea usually occurs, 9 subjects said that rhinorrhea appears during the meal, 4 people say that it comes out frequently, 2 people answered with other things. When the stroke lesions were divided into two categories (basal ganglia, thalamus vs others) and analyzed by the chi-square test, the relative risk of rhinorrhea in the stroke in basal ganglia and thalamus was 2.9. As a result of analyzing only patients with cerebral infarction, the relative risk increased to 6.26. The SNOT-22 score showed a positive correlation with the autonomic symptom questionnaire score in the rhinorrhea group (R=0.808, p<0.01). In the no-rhinorrhea group, there was also a positive correlation. But the correlation coefficient was lower than the rhinorrhea group (R=0.56, p<0.01).
Conclusion
The rhinorrhea that occurs after a stroke seems to be related to the location of the lesion. In the case of the lesion in basal ganglia or thalamus, the relative risk of rhinorrhea increases. The rhinorrhea symptom in stroke patients is highly correlated with autonomic nervous system symptoms. |
