Isolated lesion of the hypoglossal nerve as the result of an internal carotid artery aneurysm – case report

Abstract

A 56-year-old male with arterial hypertension sought for medical help for a sudden unilateral swelling of the oral tongue and changed quality of speech. An ENT examination revealed a lesion of the left hypoglossal nerve. Neurological examinations including brain imaging showed negative results. The MRI of the neck only suggested, the angiography confirmed internal carotid aneurysm in the extracranial portion causing pressure on the hypoglossal nerve. The aneurysm was treated with a flow diverter, which reroutes the blood flow and thus embolises the aneurysm. The aneurysm shrunk, its mass effect disappeared and the function of the nerve fully recovered. Keywords: case report – hypoglossal nerve – a. carotis interna – sudden appeared lesion