Delayed Bilateral Vocal Cord Paralysis Following Right Opercular-Insular Infarction

We report a case of an 84-year-old man who developed delayed bilateral vocal cord paralysis requiring tracheostomy following right middle cerebral artery infarction involving the opercular-insular region, raising the possibility that unilateral opercular-insular injury may disrupt bilateral laryngeal motor control in certain individuals, and highlighting the need for awareness of this rare but life-threatening complication after middle cerebral artery infarction.