Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Upper airway obstruction with bilateral vocal cord paralysis secondary to ischemic stroke: Reports of two cases

Yasuyuki Ito, M.D.1), Akira Mori, M.D.1), Kiminobu Yonemura, M.D.1), Yoichiro Hashimoto, M.D.1), Teruyuki Hirano, M.D.2) and Makoto Uchino, M.D.2)

1)Department of Neurology, Kumamoto City Hospital
2)Department of Neurology, Graduate School of Medical Sciences, Kumamoto University

We present herein two patients with bilateral vocal cord paralysis that occurred during the subacute phase of brain infarction. Patients were a 73-year-old man and an 82-year-old woman who suffered from infarction of the basilar artery and the right middle cerebral artery, respectively. The former was diagnosed as atherothrombotic infarction, but the patient experienced repeated aggravation. The latter was diagnosed as cardioembolic infarction. After both patients took clopidogrel and warfarin for the secondary prevention of stroke, upper airway obstruction developed at Day 29 and Day 19, respectively. Vocal cords in Case 1 did not show any movement on laryngoscopy, and were fixed together nearly closed. In Case 2, vocal cords were again almost fixed together. Bilateral vocal cord paralysis is a common complication of cervical operations, but is rare after ischemic stroke. As patients who have suffered from bilateral vocal cord paralysis are often facing death, we must be careful of wheezing with ischemic stroke.
Full Text of this Article in Japanese PDF (559K) Members Only

(CLINICA NEUROL, 48: 333|337, 2008)
key words: brain infarction, brainstem infarction, supratentorial infarction, bilateral vocal cord paralysis, tracheostomy

(Received: 28-Jun-07)