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Contralateral diaphragmatic palsy in acute stroke: An interesting observation

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Author(s): Kumar Sudhir | Reddy Rajesh | Prabhakar Subhashini

Journal: Indian Journal of Critical Care Medicine
ISSN 0972-5229

Volume: 13;
Issue: 1;
Start page: 28;
Date: 2009;
Original page

Keywords: Acute stroke | clinical implication | diaphragmatic palsy | pathophysiological basis

ABSTRACT
Diaphragmatic palsy in hemiparetic stroke is not well recognized. Further, its implications on stroke outcome have not been studied. Here, we report a patient with left-sided diaphragmatic palsy due to an acute right middle cerebral artery territory infarction. The diagnosis was suspected on finding an elevated dome of the diaphragm on the left side in a routine chest radiograph and was confirmed by finding decreased movements of the left hemidiaphragm on fluoroscopic examination. We hypothesize that this condition is probably under-recognized in clinical practice and its clinical importance not well known. The pathophysiological basis of diaphragmatic palsy in acute stroke and its possible clinical implications are discussed.

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