CTICasesTransient Diaphragmatic Paralysis Secondary to Brachial Plexus Block
Imaging findings
Preoperative chest radiographs show normal, symmetric height of the bilateral hemidiaphragms. A post-operative radiograph obtained immediately following wrist surgery demonstrates marked elevation of the right hemidiaphragm. A follow-up radiograph obtained several months later shows complete resolution and a normal diaphragmatic position.
Key takeaways
Ipsilateral diaphragmatic paralysis and phrenic nerve palsy are well-known, transient complications of interscalene brachial plexus blocks used for upper extremity regional anesthesia. Normalization of the diaphragmatic height on follow-up confirms the transient nature of the anesthetic block and rules out permanent mechanical phrenic nerve trauma.
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