Diaphragmatic Paralysis in a Patient with Spinal Cord Infarction

Matsumoto, Hideyuki; Nakayama, Takahiro; Hamaguchi, Hirotoshi; Nakamori, Tomoki; Ikagawa, Takashi; Oda, Tetsuya; Imafuku, Ichiro

doi:10.2169/internalmedicine.48.2334

Cited by 5 publications

(3 citation statements)

References 9 publications

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“…However, this relationship between PB and pleural diseases has been demonstrated in human medicine. For example, PB is reported to be a key symptom of diaphragmatic paresis in human patients, [8][9][10][11][12][13] although spontaneous diaphragmatic paresis was not observed in the present study. In people, PB has also been shown to be associated with neurologic diseases, 12,14 diaphragmatic myopathy, 9 flail chest, 10 chronic obstructive pulmonary disease, 15 upper airway obstruction, 16,17 severe abdominal distension, 18 and pleural effusion.…”

Section: Discussioncontrasting

confidence: 61%

Relationship between paradoxical breathing and pleural diseases in dyspneic dogs and cats: 389 cases (2001–2009)

Boedec¹,

Arnaud²,

Chetboul³

et al. 2012

javma

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Section: Discussioncontrasting

confidence: 61%

Relationship between paradoxical breathing and pleural diseases in dyspneic dogs and cats: 389 cases (2001–2009)

Boedec¹,

Arnaud²,

Chetboul³

et al. 2012

javma

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“…The differential diagnosis of bilateral diaphragmatic paralysis is wide ranging including such entities as acid maltase deficiency11 and spinal cord infarction 12. Classically it presents with severe orthopnoea, as when standing patients are able to expand the rib cage and relax abdominal muscles, facilitating the downward movement of the diaphragm 11.…”

Section: Discussionmentioning

confidence: 99%

A rare presentation of spinal epidural abscess

Crowest

Hughes²,

Elkins³

et al. 2011

Case Reports

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“…Ischemic infarction due to direct occlusion or hypoperfusion of feeding arteries can lead to ASAS [ 3 ]. Only a few cases have been described where diaphragmatic paralysis persisted, while tetraplegia receded after SCI [ 4 ]. This is, to our knowledge, the first patient fully recovering from tetraplegia due to SCI continuing to present bilateral diaphragmatic paralysis resulting in weaning failure from mechanical ventilation.…”

Section: Introductionmentioning

confidence: 99%

Weaning failure due to isolated residual diaphragmatic paralysis after cervical spinal cord ischemia following aortic surgery- a case report

Overbeek,

Behrens,

Zopfs

et al. 2024

BMC Anesthesiol

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Background Bilateral diaphragmatic dysfunction can lead to dyspnea and recurrent respiratory failure. In rare cases, it may result from high cervical spinal cord ischemia (SCI) due to anterior spinal artery syndrome (ASAS). We present a case of a patient experiencing persistent isolated diaphragmatic paralysis after SCI at level C3/C4 following thoracic endovascular aortic repair (TEVAR) for Kommerell’s diverticulum. This is, to our knowledge, the first documented instance of a patient fully recovering from tetraplegia due to SCI while still exhibiting ongoing bilateral diaphragmatic paralysis. Case presentation The patient, a 67-year-old male, presented to the Vascular Surgery Department for surgical treatment of symptomatic Kommerell’s diverticulum in an aberrant right subclavian artery. After successful surgery in two stages, the patient presented with respiratory insufficiency and flaccid tetraparesis consistent with anterior spinal artery syndrome with maintained sensibility of all extremities. A computerized tomography scan (CT) revealed a high-grade origin stenosis of the left vertebral artery, which was treated by angioplasty and balloon-expandable stenting. Consecutively, the tetraparesis immediately resolved, but weaning remained unsuccessful requiring tracheostomy. Abdominal ultrasound revealed a residual bilateral diaphragmatic paralysis. A repeated magnetic resonance imaging (MRI) 14 days after vertebral artery angioplasty confirmed SCI at level C3/C4. The patient was transferred to a pulmonary clinic with weaning center for further recovery. Conclusions This novel case highlights the need to consider diaphragmatic paralysis due to SCI as a cause of respiratory failure in patients following aortic surgery. Diaphragmatic paralysis may remain as an isolated residual in these patients.

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Diaphragmatic Paralysis in a Patient with Spinal Cord Infarction

Abstract: This report describes the rare case of a 72-year-old

Cited by 5 publications

References 9 publications

Relationship between paradoxical breathing and pleural diseases in dyspneic dogs and cats: 389 cases (2001–2009)

Relationship between paradoxical breathing and pleural diseases in dyspneic dogs and cats: 389 cases (2001–2009)

A rare presentation of spinal epidural abscess

Weaning failure due to isolated residual diaphragmatic paralysis after cervical spinal cord ischemia following aortic surgery- a case report

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