Spontaneous carotid dissection with hypoglossal nerve palsy as residual deficit: the importance of magnetic resonance evaluation

Bezerra, Marcio Luiz Escorio; Pedroso, José Luiz; Pieri, Alexandre

doi:10.1590/s0004-282x2009000600030

Cited by 3 publications

(3 citation statements)

References 8 publications

(17 reference statements)

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“…This observation may be related to a significantly better understanding of the relevance of guidelines for the participants possessing an OMPT specialization. Although an increasing number of primary studies suggest the importance of CNE when examining the neck region to inform pattern recognition of sinister clinical conditions [13,47,[49][50][51][52][53][54][55][56][57][58][59][60][61][62][63], our findings may reflect the lack of high-quality evidence for CN involvement in NAD IV. To the best of the authors' knowledge, no specific data are available to support the diagnostic accuracy of a complete CNE.…”

Section: Key Findingsmentioning

confidence: 95%

“…Subtle transient neurological signs and symptoms, such as headache (81%), neck pain (57-80%), dizziness (32%), visual disturbance (34%), paresthesia (19-34%) [18], CN palsies [12,13,[52][53][54][55][56][57][58], Horner' syndrome, and tinnitus [54], are common predictors of potential serious pathologies (e.g., vascular pathologies) [18]. The cause of these conditions can be disabling or even lethal; therefore, understanding how to recognize, diagnose, and appropriately evaluate them is of great importance to all clinicians.…”

Section: Key Findingsmentioning

confidence: 99%

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Assessing Cranial Nerves in Physical Therapy Practice: Findings from a Cross-Sectional Survey and Implication for Clinical Practice

et al. 2021

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Background and objective: Serious pathologies of the neck can potentially result in cranial nerve palsy. Knowledge about cranial nerve examination (CNE) seems sparse, and its use is still unknown. We aim to investigate the knowledge, skills, and utilization of CNE of Italian physiotherapists. Materials and Methods: An online cross-sectional survey. Results: 396 completed the survey, reaching the required sample size. Although Italian physiotherapists consider CNE relevant (mean ± SD = 7.6/10 ± 2.0), over half of all responders (n = 229 (57.8%)) were not trained in the fundamentals and around a third did not use it in their daily practice (n = 138 (34.8%)). Additionally, participants were unconfident and insecure in conducting (n = 152 (38.4%) and n = 147 (37.1%)), interpreting (n = 140 (35.4%) and n = 164 (41.4%)), and managing the CNE (n = 141 (35.6%) and n = 154 (38.9%)). Possessing a musculoskeletal specialization was associated with an increased value attributed to clinical practice guidelines and reduced the lack of confidence in conducting, interpreting, and managing the CNE (respectively, n = 35 (25.5%), p = 0.0001; n = 32 (23.4%) p = 0.0002; n = 32 (23.4%) p = 0.0002). Working in a direct access setting significantly increased the considered relevance of guidelines and the concerns about arterial (p = 0.004) and other serious pathologies (p = 0.021). Pain and visual disturbances were considered the main indicators to CNE, demonstrating limited knowledge of signs and symptoms’ indicating CNE. Participants considered specific training in CNE as relevant (mean ± SD = 7.6/10 = 2.1). Conclusions: a substantial proportion of Italian physiotherapists are not schooled in the fundamentals of cranial nerve examination. Given the number of physiotherapists who work in first contact roles, this is a professional concern.

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Section: Key Findingsmentioning

confidence: 95%

Section: Key Findingsmentioning

confidence: 99%

Assessing Cranial Nerves in Physical Therapy Practice: Findings from a Cross-Sectional Survey and Implication for Clinical Practice

et al. 2021

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“…In patients exhibiting end-group cranial nerve palsy, which occurs in 3-12% of ICAD cases (17), Collet-Sicard syndrome and Villaret's syndrome often develop (18,19). The hypoglossal nerve is one of the most frequently affected cranial nerves in ICAD (6,14,16,20). Hypoglossal nerve palsy may result from the compression of surrounding structures by the dilated dissecting aneurysm or involvement of blood vessels that supply blood to the cranial nerves.…”

Section: Introductionmentioning

confidence: 99%

Bilateral dissecting aneurysms of the internal carotid arteries misdiagnosed as skull base tumors: A case report

et al. 2015

Oncology Letters

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Abstract.A 45-year-old female presented with a five-year history of intermittent headaches and a two-month history of left hypoglossal nerve palsy. Computed tomography and magnetic resonance imaging of the head revealed space-occupying lesions in the base of the skull with accompanying bone erosion, which were suggestive of skull base chordomas. However, an endoscopic endonasal transsphenoidal biopsy was also performed and pathological analysis of the lesion suggested a thrombosis. Cranial magnetic resonance angiography revealed old dissecting aneurysms of the bilateral internal carotid arteries (ICAs), which led to a definitive diagnosis. The patient was successfully treated with anticoagulants and antiplatelet agents. The present case study suggests that, for patients with space-occupying lesions of the skull base and symptoms of cranial nerve palsy, the possibility of an ICA dissection should be prioritized during the differential diagnosis.

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Hypoglossal nerve palsy as an isolated syndrome of internal carotid artery dissection: A review of the literature and a case report

Mes

Palczewski

Szczudlik

et al. 2018

Neurologia i Neurochirurgia Polska

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Spontaneous carotid dissection with hypoglossal nerve palsy as residual deficit: the importance of magnetic resonance evaluation

Abstract: diSSecÇÃo eSpontÂnea de carÓtida coM paraliSia reSidual do nervo hipogloSSo: a iMportÂncia da avaliaÇÃo por reSSonÂncia MagnÉtica

Cited by 3 publications

References 8 publications

Assessing Cranial Nerves in Physical Therapy Practice: Findings from a Cross-Sectional Survey and Implication for Clinical Practice

Assessing Cranial Nerves in Physical Therapy Practice: Findings from a Cross-Sectional Survey and Implication for Clinical Practice

Bilateral dissecting aneurysms of the internal carotid arteries misdiagnosed as skull base tumors: A case report

Hypoglossal nerve palsy as an isolated syndrome of internal carotid artery dissection: A review of the literature and a case report

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