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Related Experiment Videos

Vocal cord paresis in acute ischemic stroke.

N Venketasubramanian1, R Seshadri, N Chee

  • 1Department of Neurology, Tan Tock Seng Hospital, Singapore, Singapore. ramani_nv@notes.ttsh.gov.sg

Cerebrovascular Diseases (Basel, Switzerland)
|April 20, 1999
PubMed
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Vocal cord paresis (VCP) is common in acute ischemic stroke patients, affecting over 20%. This finding challenges the assumption of bilateral brainstem innervation, impacting voice function after stroke.

Area of Science:

  • Neurology
  • Otolaryngology

Background:

  • Acute ischemic stroke can lead to various neurological deficits.
  • Vocal cord paresis (VCP) is a potential complication affecting voice quality.
  • The supranuclear innervation of the nucleus ambiguus is traditionally considered bilateral.

Purpose of the Study:

  • To determine the frequency of vocal cord paresis (VCP) in patients experiencing their first acute ischemic stroke.
  • To investigate the relationship between stroke location and VCP.
  • To examine the laterality of VCP relative to the brain lesion.

Main Methods:

  • Prospective study involving 54 first-ever acute ischemic stroke patients.
  • Endoscopic examination of vocal cords within 48 hours, 1 week, and 1 month of stroke onset.

Related Experiment Videos

  • Classification of stroke infarcts into lacunar, cortical/large subcortical, lateral medulla, and other brainstem types.

    • Main Results:

    • VCP was detected in 20.4% of patients.
    • Frequency varied by stroke type: 11.4% (lacunar), 16.4% (cortical/large subcortical), 100% (lateral medulla), 0% (brainstem).
    • VCP was contralateral to the lesion in cortical/subcortical strokes and ipsilateral in 80% of lateral medulla strokes. VCP strongly correlated with dysphonia.

    Conclusions:

    • Vocal cord paresis is a frequent complication of acute ischemic stroke.
    • The high incidence of VCP, particularly with lateral medulla strokes, suggests a potential vulnerability in the neural pathways controlling vocal cord function.
    • Findings question the long-held belief in invariable bilateral supranuclear innervation of the nucleus ambiguus.