Hypoglossal nerve palsy caused by an aneurysm of the external carotid artery

Abstract Background Internal carotid artery dissection has been well recognized as a major cause of ischaemic stroke in young and middle-aged adults. However, internal carotid artery dissection induced hypoglossal nerve palsy has been seldom reported and may be difficult to diagnose in time for treatment; even angiography sometimes misses potential dissection, especially when obvious lumen geometry changing is absent. Case presentation We report a 42-year-old man who presented with isolated hypoglossal nerve palsy. High-resolution MRI showed the aetiological dissected internal carotid artery. In addition, a potential genetic structural defect of the arterial wall was suggested due to an exon region mutation in the polycystic-kidney-disease type 1 gene. Conclusions Hypoglossal nerve palsy is a rare manifestations of carotid dissection. High-resolution MRI may provide useful information about the vascular wall to assist in the diagnosis of dissection. High-throughput sequencing might be useful to identify potential cerebrovascular-related gene mutation, especially in young individuals with an undetermined aetiology.

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Electrothrombosis of Spontaneous Carotid-Cavernous Fistula by Copper Needle Insertion

Neurosurgery ◽

10.1097/00006123-198404000-00002 ◽

1984 ◽

Vol 14 (4) ◽

pp. 400-405 ◽

Cited By ~ 1

Author(s):

Nishijima Michiharu ◽

Kamiyama Kazuyo ◽

Oka Nobuo ◽

Endo Shunro ◽

Takaku Akira

Keyword(s):

Carotid Artery ◽

Nerve Palsy ◽

Internal Carotid ◽

Needle Insertion ◽

External Carotid Artery ◽

External Carotid ◽

Carotid Cavernous Fistula ◽

Intraoperative Angiography ◽

Cavernous Fistula ◽

Gerstmann’S Syndrome

Abstract Electrothrombosis by copper needle insertion was used to treat three cases of spontaneous carotid-cavernous fistula. These patients had been treated conservatively for 6 months or more, but their symptoms had not improved. Angiography showed that the feeding arteries were branches of both the ipsilateral internal and the ipsilateral external carotid artery. Frontotemporal craniotomy was performed, and copper needles were inserted transdurally into the cavernous sinus. Closure of the fistula was verified by intraoperative angiography in all cases, and the symptoms improved after the operation. However, one patient had postoperative transient 3rd nerve palsy. Another had Gerstmann's syndrome due to narrowing of the internal carotid artery by a needle and worsening of the preoperative 6th nerve palsy. In one case, the operation was uneventful. Based on our experience, we discuss several problems with this technique.

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Unilateral isolated hypoglossal nerve palsy associated with internal carotid artery dissection

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2013-304923 ◽

2013 ◽

Vol 84 (6) ◽

pp. 706-706 ◽

Cited By ~ 10

Author(s):

J. Riancho ◽

J. Infante ◽

J. I. Mateo ◽

J. Berciano ◽

L. Agea

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Nerve Palsy ◽

Internal Carotid ◽

Hypoglossal Nerve ◽

Carotid Artery Dissection ◽

Artery Dissection ◽

Internal Carotid Artery Dissection ◽

Hypoglossal Nerve Palsy

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Ipsilateral hypoglossal nerve palsy in internal carotid artery dissection

10.26226/morressier.5af5cdae738ab1001baf50e8 ◽

2018 ◽

Author(s):

Bilal Ibrahim

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Nerve Palsy ◽

Internal Carotid ◽

Hypoglossal Nerve ◽

Carotid Artery Dissection ◽

Artery Dissection ◽

Internal Carotid Artery Dissection ◽

Hypoglossal Nerve Palsy

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Variations, relations and clinical significance of carotid arterial system in anterior neck: a cadaveric study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20191311 ◽

2019 ◽

Vol 7 (4) ◽

pp. 1127

Author(s):

Anasuya Ghosh ◽

Subhramoy Chaudhury ◽

Atin Datta

Keyword(s):

Carotid Artery ◽

Carotid Arteries ◽

Internal Carotid ◽

Hypoglossal Nerve ◽

Carotid Bifurcation ◽

External Carotid Artery ◽

Arterial System ◽

External Carotid ◽

The Common ◽

Carotid Arterial

Background: The common carotid, internal and external carotid arteries and their branches serve as major source of blood supply in head-neck region of human and are often encountered during numerous surgical and clinical interventions of neck.Methods: We dissected and examined both sides of neck in 49 well embalmed cadavers (98 sides). We recorded the following anatomical parameters of carotid arterial system-level of bifurcation, the relation between internal and external carotid arteries, branching pattern of anterior branches of external carotid artery, tortuosity in carotid arterial system, and relation of hypoglossal nerve with the carotid arteries.Results: In 56.16 % cases, the common carotid arterial bifurcation took place at the upper border of thyroid cartilage though high bifurcation was quite common (43.88%). The external carotid artery was located antero-medial to internal carotid artery in most cases (93.87%). Abnormal tortuosity of carotid arterial system was detected in 2.04% cases only. In 86.73% cases, the hypoglossal nerve crossed the internal and external carotid artery superior to carotid bifurcation above the level of hyoid bone while in 1 case it crossed immediately inferior to carotid bifurcation. In branching pattern, following variations were observed- linguo-facial trunk in 15.3% cases, thyro-lingual trunk in 5.1% cases, origin of superior thyroid artery from common carotid in 10.02% cases and origin of superior thyroid from internal carotid in one case (1.02%).Conclusions: The carotid arterial system has complex and variable anatomy in neck and this information should be kept in mind to avoid unwanted damage during surgical procedures of neck.

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