Central line catheterisation as a cause of vocal cord palsy

We report an unusual case of vocal cord palsy secondary which developed following insertion of a central line. A 46-year-old gentleman was admitted with seizure activity and reduced GCS. Following failed attempts at establishing intravenous or intraosseous access, a central line was placed into the right internal jugular vein. After extubation, the patient was found to have a right vocal cord palsy. Contemporaneous computed tomography (CT) imaging of the neck and thorax was performed to determine the cause of the palsy. Although this CT was clear, review of the original trauma CT showed a haematoma within the right carotid sheath. This led to a diagnosis of neuropraxia secondary to haematoma from central venous catheterisation. The patient went on to make a full recovery. We discuss our case with review of previous literature and discussion of management in such situations.