{Reference Type}: Case Reports {Title}: Delayed vagal nerve compressive neuropathy following placement of vagal nerve stimulator: case report. {Author}: McGrath H;Pennington Z;Cross MR;Hoffman EM;Gregg NM;Tasche KK;Bayan SL;Van Gompel JJ; {Journal}: Acta Neurochir (Wien) {Volume}: 166 {Issue}: 1 {Year}: 2024 Apr 25 {Factor}: 2.816 {DOI}: 10.1007/s00701-024-06087-x {Abstract}: Vagal neuropathy causing vocal fold palsy is an uncommon complication of vagal nerve stimulator (VNS) placement. It may be associated with intraoperative nerve injury or with device stimulation. Here we present the first case of delayed, compressive vagal neuropathy associated with VNS coil placement which presented with progressive hoarseness and vocal cord paralysis. Coil removal and vagal neurolysis was performed to relieve the compression. Larger 3 mm VNS coils were placed for continuation of therapy. Coils with a larger inner diameter should be employed where possible to prevent this complication. The frequency of VNS-associated vagal nerve compression may warrant further investigation.