title: Laterality of Pneumonia in Acute Stroke.
abstract: Previous studies demonstrated an alteration of diaphragmatic excursion on the paretic side after stroke; however, it is unclear if this change has clinical repercussions. We aimed to determine if there was an association between the paretic side and the laterality of pneumonia after stroke.
  
  
  
  A retrospective analysis of a consecutive cohort of patients admitted to a stroke unit from 2008 to May 2016 was performed. Patients with the diagnosis of acute stroke and pneumonia were included. The laterality of pneumonia was determined through the blinded observation of chest X-rays. Fisher's exact test was applied to study the association between the side of paresis and pneumonia.
  
  
  
  One hundred and five patients were included. Sixty one percent (n = 64) had an ischemic stroke, 39% (n = 41) had brain hemorrhage, and 49.5% (n = 52) had right side paresis. We did not find in general an association between the side of paresis and the side of pneumonia (p = 1.00); however, we found a statistically significant association in patients with severe lower limb paresis (Medical Research Council, MRC ≤2; p = 0.035).
  
  
  
  We found an association between severe paresis of the lower limb (MRC ≤2) and ipsilateral pneumonia. We hypothesize that the proximity between the diaphragmatic and inferior limb corticospinal pathways could be the reason for this association.
authors.affiliation: Department of Infectious Diseases, Hospital Fernando da Fonseca, Amadora, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Nascimento Alves
authors.forename: Cristiana
authors.initials: C
authors.lastname: Silva
authors.forename: Joana
authors.initials: J
authors.lastname: Baptista
authors.forename: Bárbara
authors.initials: B
authors.lastname: Lima
authors.forename: Margarida
authors.initials: M
authors.lastname: Jacinto
authors.forename: Frederico
authors.initials: F
authors.lastname: Trigueiros
authors.forename: André
authors.initials: A
authors.lastname: Martins
authors.forename: Teresa
authors.initials: T
authors.lastname: Pinho E Melo
authors.forename: Ana Catarina
authors.initials: AC
authors.lastname: Fonseca
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000150:complications; D011014:Pneumonia / Q000209:etiology* / Q000473:pathology*; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications*