Within the stroke population, patients with bilateral hemispheric strok´╗┐e exhibit the most severe and most persistent dysphagia characteristics and are therefore at a higher risk of developing associated complications (Neumann, 1993).

Each patient will present differently depending on the location of the lesions in their brain and the functional consequences of the damage (Groher and Crary, 2010). However, considering the severity of the dysphagia a patient with bilateral hemispheric stroke will present with, the main priorities for intervention during the acute stroke phase are:
1. Managing the risk of aspiration and consequent development of pneumonia.

2. Maintaining and promoting nutrition and hydration.

In addition to sensory and motor swallowing deficits, a patient with bilateral hemispheric stroke may present with several co-morbid conditions which require substantial consideration when deciding the appropriate course of management for each patient. Click here to learn more about co-morbid conditions.
Evidence exists showing that spontaneous recovery of some swallowing function after stroke does occur during the acute stage therefore, part of the management of a patient with dysphagia should involve ongoing swallowing assessment throughout their time in hospital to ensure that each individual patient is receiving the most appropriate form of treatment for their condition (Daniels and Huckabee, 2008).