Head injury patient with bilateral vocal cord paralysis: a mistake and a lesson learnt.

Bilateral recurrent nerve palsy along with head injury is a rare clinical possibility and can be potentially fatal if not properly diagnosed. We report a case of a head injury patient with intact Glasgow Coma Scale requiring immediate re-intubation and tracheostomy after extubation failure as a result of stridor and severe dyspnoea with paradoxical respiratory pattern, possibly because of undiagnosed significant surgical history.