Diaphragm paralysis caused by transverse cervical artery compression of the phrenic nerve: The Red Cross syndrome

In an innovative case series published in Clinical Neurology and Neurosurgery, Kaufman et al. introduce the concept of "Red Cross Syndrome" - a newly identified cause of diaphragm paralysis resulting from vascular compression of the phrenic nerve.

Methodology and Patient Cohort

The study describes three patients who developed diaphragm paralysis due to compression of the phrenic nerve by the transverse cervical artery in the neck. Two cases followed traction injuries, while one occurred after an interscalene nerve block. All patients underwent surgical decompression of the phrenic nerve.

Key Findings

The results of this small series are promising:

1. All three patients experienced restoration of diaphragm function following surgical decompression
2. Intraoperative findings confirmed vascular compression of the phrenic nerve
3. Surgical treatment involved ligation of the compressing artery and release of adhesions
4. Patients reported improvements in respiratory symptoms post-surgery

Implications for Clinical Practice

This newly identified syndrome offers several important insights:

• Introduces a potentially reversible cause of diaphragm paralysis
• Highlights the importance of considering vascular compression in cases of phrenic nerve dysfunction
• Provides a surgical treatment option for select cases of diaphragm paralysis

While more research is needed, recognition of this syndrome could improve the outcomes for patients with unexplained phrenic nerve dysfunction.

Please refer to the full article for a detailed description of "Red Cross Syndrome" and its surgical management.

As we continue to expand our understanding of phrenic nerve pathologies, recognition of entities like the Red Cross Syndrome may lead to more targeted and effective treatments for diaphragm paralysis.