Isolated hypoglossal nerve palsy due to internal carotid artery dissection

Shahab, R.; Savy, Lloyd; Croft, C. B.; Hung, Tsung‐Min

doi:10.1258/0022215011908324

Cited by 9 publications

(6 citation statements)

References 4 publications

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“…Isolated hypoglossal nerve palsy has been documented with hypoglossal nerve schwannomas, 22 dural arteriovenous fistulas, 3 enlarged emissary veins of the hypoglossal canal, 28 aneurysms of the stump of a persistent hypoglossal artery, 1 occipital condyle fractures, 8,20 arachnoid cysts, 4 after neck surgery, 26,30 metastatic lesions to the skull base, 13,23 internal carotid 21,27 and vertebral artery dissections, 18 and with no apparent cause. 12 To our knowledge, only 2 cases of isolated hypoglossal nerve palsy secondary to an atlantooccipital juxtafacet cyst have been reported in the literature (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Isolated unilateral hypoglossal nerve palsy secondary to an atlantooccipital joint juxtafacet synovial cyst

Elhammady¹,

Farhat²,

Aziz-Sultan³

et al. 2009

SPI

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Juxtafacet cysts of the atlantooccipital joint that present with isolated hypoglossal nerve palsy are rare and may mimic more common pathological entities. The authors report on the third such case in the literature and discuss the differential diagnosis, imaging hallmarks, preoperative recognition, and surgical management of this lesion, and provide a review of the literature. The authors discuss their experience with the treatment of a 67-year-old woman who presented with an isolated hypoglossal nerve palsy caused by a nonenhancing cystic septated lesion abutting the lateral medulla just medial to the left hypoglossal canal. The lesion was presumed to be a necrotic hypoglossal schwannoma or epidermoid tumor. Intradural surgical exploration failed to demonstrate an intradural lesion, but confirmed the presence of an extradural mass caudal to the hypoglossal nerve. Extradural exploration revealed a synovial cyst of the atlantooccipital joint, which was then resected. Postoperatively, the patient developed worsening dysphagia and hoarseness. Failure to recognize this rare entity preoperatively resulted in unnecessary intradural exploration and cranial nerve morbidity. In retrospect, the preoperative diagnosis of this lesion was suggested by lack of central enhancement, absence of dumbbell formation and the presence of erosive synovial changes. Regardless, the extreme rarity of this lesion at this location will always make its recognition challenging.

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Section: Discussionmentioning

confidence: 99%

Isolated unilateral hypoglossal nerve palsy secondary to an atlantooccipital joint juxtafacet synovial cyst

Elhammady¹,

Farhat²,

Aziz-Sultan³

et al. 2009

SPI

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“…The commonest iatrogenic surgical causes of palsy include carotid endarterectomy and submandibular gland excision 5 , 11 , 12 . Radiotherapy has a particular predilection for the XIIth cranial nerve, causing damage either directly or indirectly via vascular ischaemia or fibrosis in the surrounding tissues 2 , 11…”

Section: Discussionmentioning

confidence: 99%

“…Combining smaller series specific to an isolated palsy, only 20 cases are available in the literature (Table I). 2 More commonly, the hypoglossal nerve is involved along with the glossopharyngeal, vagus and spinal accessory nerves within the nearby jugular foramen 3 , 9 , 10 Table IPUBLISHED CASES OF TRULY ISOLATED HYPOGLOSSAL NERVE PALSYCombarros et al , 1 Giuffrida et al , 6 Tommasi-Davenas et al 8 …”

Section: Introductionmentioning

confidence: 99%

Isolated hypoglossal nerve palsy: a harbinger of malignancy

et al. 2007

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The hypoglossal nerve is an underrated nerve usually consigned to a few words in anatomical text books, under the last four cranial nerves. However, paralysis of this nerve may be the first indication of a serious underlying disorder. Excluding previous surgery, radiotherapy and trauma, 50 per cent of cases of isolated hypoglossal nerve palsy are idiopathic. A further 20 per cent are malignant, 20 per cent are vascular and 10 per cent are due to miscellaneous causes. Presentation of an isolated hypoglossal nerve palsy is therefore an ominous sign. There is confusion over both cause and investigation, and management protocols for isolated hypoglossal nerve palsy are ill-defined. We present a case of isolated hypoglossal palsy which was due to a metastatic skull base deposit. This case illustrates the fact that magnetic resonance imaging is the investigation of choice in assessing the entire course of the hypoglossal nerve.

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“…Discussion 28 and nonophthalmologic cranial neuropathy. 29 The presence of multisystem injuries to include primary cerebral injuries can make the assessment of signs and symptoms of traumatic CD difficult. The clinician is often forced to pursue a "veterinary medicine" approach to these patients to arrive at a diagnosis of CD.…”

Section: Clinical Presentationmentioning

confidence: 99%

Carotid Dissection: A Clinical Review

2002

Seminars in Neurosurgery

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Carotid artery dissection (CD) is an unusual pathological entity capable of producing devastating neurological deficits in affected patients. Symptoms include one or more of the clinical triad of headaches, oculosympathetic dysfunction, and retinal or cerebral ischemia. Cerebral angiography remains the gold standard for the diagnosis of carotid dissection. However, magnetic resonance angiography (MRA) and computed tomographic angiography (CTA) are emerging as both sensitive and specific modalities for the diagnosis of carotid artery disease. Management of CD remains controversial; the efficacy of anticoagulation, the current standard of care for initial management of CD, has not been demonstrated in a clinical trial. The authors review management options to include anticoagulation, antiplatelet agents, endovascular stenting, and surgical management of carotid dissection.Objectives: Upon completion of this article, the reader will be familiar with the current diagnostic and treatment options available for the management of spontaneous and traumatic carotid dissection.

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Isolated hypoglossal nerve palsy due to internal carotid artery dissection

Cited by 9 publications

References 4 publications

Isolated unilateral hypoglossal nerve palsy secondary to an atlantooccipital joint juxtafacet synovial cyst

Isolated unilateral hypoglossal nerve palsy secondary to an atlantooccipital joint juxtafacet synovial cyst

Isolated hypoglossal nerve palsy: a harbinger of malignancy

Carotid Dissection: A Clinical Review

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