Influence of location of paresis on site of pneumonia in stroke

Introduction Stroke can cause unilateral paresis of the diaphragm. It is, however, unknown if diaphragm paresis can lead to post-stroke pneumonias. We aimed to evaluate whether the location of post-stroke paresis influenced the location of pneumonia. Methods This is a retrospective study of all patients admitted to stroke unit in 2006–2009 with a diagnosis of acute ischemic stroke or intracerebral hemorrhage who had hemiparesis or hemiplegia, and who were diagnosed with unilateral pneumonia based on chest radiogram. Results Of 1394 patients with a diagnosis of stroke, 64 (5%) patients met the study criteria. Of 35 patients with motor deficit on the left side, 18 (51%) developed pneumonia on the left and 17 (49%) on the right side (p=0.90). Of 29 patients with motor deficit on the right side, 17 (59%) developed pneumonia on the right and 12 (41 %) on the left side (p=0.51). Thus, of all 64 patients, 35 (55%) had pneumonia on the same side as the paresis and 29 (45%) on the contralateral side (p=0.60). Conclusions There was no significant occurrence of pneumonia on the side of paresis. Therefore, the side of paresis is not likely to be a helpful clinical marker of diaphragm paresis.