Bilateral vocal cord palsy due to brain-stem cavernoma--a diagnostic dilemma!

Vocal cord palsy may result from varied causes. However, cord palsy resulting from a brain-stem cavernoma has never been reported. We report a patient with vocal cord palsy in a 30-year-old male resulting from the brain-stem lesion. The patient became symptomatic each time the lesion bled and improved gradually when the bleeding resolved. Repeated insults on the brain-stem produced permanent cord palsy. Although a rare presentation, brain-stem cavernoma may be considered in the aetiology of cord palsy.