Abstract
DIAPHRAGMATIC paralysis in patients with head injury is clinically important for two reasons: (1) it can aggravate the inevitable respiratory problems in the immediate postinjury period, and (2) it can contribute to recurrent pulmonary problems during the recovery phase. The clinical course of two children described here document these problems. During the first few days of treatment of acute head injury, attention is directed toward life-threatening problems such as intracranial bleeding, cerebral edema, and internal bleeding. Some of the less important injuries, such as fractures of the clavicle and fingers, are very often recognized during the recovery phase. One such injury that is important to be recognized during the rehabilitation phase of head injury is phrenic nerve paralysis. We have treated two children with head injury in whom recurrent respiratory problems have been associated with phrenic nerve paralysis. A third child had a clinical picture compatible with this diagnosis, but
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