Case Report Internal Carotid Artery Dissection Presenting as Isolated Hypoglossal Nerve Palsy – A Case Report
Hypoglossal palsy in carotid dissection
DOI:
https://doi.org/10.15713/ins.bhj.167Keywords:
Carotid dissection, Hypoglossal nerve palsy, Treatment of dissectionAbstract
As compared to other cranial nerves, hypoglossal nerve palsy is rare; and is often associated with other lower cranial nerve
palsies. The most common causes of hypoglossal nerve palsies are tumors followed by trauma, stroke, surgery, infection, and
multiple sclerosis. We report a case of a 55-year-old male presenting with dysphagia, dysarthria, and difficult mastication. He
was diagnosed to have isolated hypoglossal nerve palsy secondary to compression by internal carotid artery dissection (ICAD).
He was treated conservatively with antiplatelets and showed improvement on a 6-month follow-up. ICAD is a dangerous entity
with possible endangering complications and hence recognition of it is critical for appropriate treatment and prevention of
possible complications. ICAD should be considered in differential diagnosis for isolated hypoglossal nerve palsy.
References
Stino AM, Smith BE, Temkit M, Reddy SN. Hypoglossal nerve
palsy: 245 cases. Muscle Nerve 2016;54:1050-4.
Schievink WI. Spontaneous dissection of the carotid and vertebral
arteries. N Engl J Med 2001;344:898-906.
Lee VH, Brown RD, Mandrekar JN, Mokri B. Incidence and
outcome of cervical artery dissection: A population-based study.
Neurology 2006;67:1809-12.
Campos-Herrera CR, Scaff M, Yamamoto FI, Conforto AB.
Spontaneous cervical artery dissection: An update on clinical and
diagnostic aspects. Arq Neuropsiquiatr 2008;66:922-7.
Jurkiewicz MT, Stein JM, Learned KO, Nasrallah IM, Loevner LA.
Hypoglossal nerve palsy due to carotid artery dissection: An
uncommon presentation of a common problem. Neuroradiol J
;32:123-6.
Sturzenegger M, Huber P, Sturzenegger M. Cranial nerve palsies
in spontaneous carotid artery dissection. J Neurol Neurosurg
Psychiatry 1993;56:1191-9.
Murakami Y, Oda K, Konno Y, Matsumoto Y, Saito K. Successfully
treated with endovascular therapy against lower cranial nerve
paresis caused by spontaneous dissection of the cervical internal
carotid artery: A case report. J Neuroendovasc Ther 2016;10:30-5.
Kidoguchi T, Fukui I, Abe H, Mori K, Tamase A, Yamashita R,
et al. Carotid artery stenting for spontaneous internal carotid
artery dissection presenting with hypoglossal nerve palsy: A case
report. Surg Neurol Int 2022;13:225.
Markus HS, Levi C, King A, Madigan J, Norris J. Antiplatelet
therapy vs anticoagulation therapy in cervical artery dissection:
The cervical artery dissection in stroke study (cadiss) randomized
clinical trial final results. JAMA Neurol 2019;76:657-64.
Zeleňák K, Zeleňáková J, DeRiggo J, Kurča E, Kantorová E,
Poláček H. Treatment of cervical internal carotid artery
spontaneous dissection with pseudoaneurysm and unilateral
lower cranial nerves palsy by two silk flow diverters. Cardiovasc
Intervent Radiol 2013;36:1147-50.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Bombay Hospital Journal

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.