scholarly journals Efficacy of Endovascular Surgery for Unruptured Internal Carotid Artery Aneurysms Presenting with Cranial Nerve Symptoms

2007 ◽  
Vol 13 (1_suppl) ◽  
pp. 163-169 ◽  
Author(s):  
S. Suzuki ◽  
A. Kurata ◽  
S. Kan ◽  
M. Yamada ◽  
J. Niki ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Complete Resolution ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Endovascular Surgery ◽  
Detachable Coils ◽  
The Mean

Whether endovascular surgery is able to reduce the mass effects of unruptured aneurysms is still controversial, although some reports have suggested efficacy in cases of internal carotid artery aneurysms with cranial nerve palsy. Here we assessed outcome in a series of cases. Between April 1992 and April 2005, 18 patients with unruptured internal carotid artery aneurysms presenting with cranial nerve palsy were treated by endovascular surgery. The patients were two males and 16 females aged from 19 to 84 (mean 59.6 years). Aneurysms were located in the cavernous portion in 14, at the origin of the ophthalmic artery in one and at the origin of P-com in three. The aneurysms were all embolized using Guglielmi detachable coils, Interlocking detachable coils, Cook's detachable coils or Trufill DSC and detachable Balloons were applied to occlude the proximal parent artery. We analyzed the efficacy of endovascular surgery for such aneurysms retrospectively. The mean aneurysm size was 21.4 mm and the mean follow-up period was 57.7 months. Palsy of IInd cranial nerve was evident in three patients, of the IIIrd in eight, of the Vth and Vth in one each, and of the VIth in nine. Post embolization occlusion was complete in nine patients and neck remnant in the other seven. Regarding complications of endovascular surgery, one case (5.6%) showed TIA after embolization. Overall 11 (46%) cranial nerve symptoms showed complete resolution, eight (33%) showed some improvement, and five (21%) were unchanged. In three cases (12.5%), the symptoms worsened after treatment. The shorter the duration of symptoms was a factor predisposing to resolution of symptoms. In complete resolution cases, the timing of treatment after symptoms appeared and the time of complete resolution were in proportion. These results showed that there is no difference in reduction of mass effects between surgical clipping and endovascular surgery for unruptured internal carotid artery aneurysms. With endovascular surgery, the rapidity of treatment after symptoms is the most important factor for successful results.

scholarly journals Spontaneous Internal Carotid Artery Dissection with Lower Cranial Nerve Palsy

2001 ◽  
Vol 28 (3) ◽  
pp. 265-269 ◽  
Author(s):  
N. Guy ◽  
D. Deffond ◽  
N. Carriere ◽  
G. Dordain ◽  
P. Clavelou ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Horner’S Syndrome ◽  
Horner's Syndrome ◽  
Lower Cranial Nerve ◽  
Lower Cranial Nerve Palsy

Background:Typical presentation of spontaneous internal carotid artery (ICA) dissection is an ipsilateral pain in neck and face with Horner's syndrome and contralateral deficits. Although rare, lower cranial nerve palsy have been reported in association with an ipsilateral spontaneous ICA dissection.Case studies:We report three new cases of ICA dissection with lower cranial nerve palsies.Results:The first symtom to appear was headache in all three patients. Examination disclosed a Horner's syndrome in two cases (1 and 2), an isolated XIIth nerve palsy in two patients (case 1 and 3) and IX, X, and XIIth nerve palsies (case 2) revealing an ipsilateral carotid dissection, confirmed by MRI and angiography. In all cases, prognosis was good after a few weeks.Conclusion:These cases, analysed with those in the literature, led us to discuss two possible mechanisms: direct compression of cranial nerves by a subadventitial haematoma in the parapharyngeal space or ischemic palsy by compression of the ascending pharyngeal artery.

Lower Cranial Nerve Palsy due to Dissection of the Internal Carotid Artery

1989 ◽  
Vol 13 (6) ◽  
pp. 989-995 ◽  
Author(s):  
Giancarlo Dal Pozzo ◽  
Mario Mascalchi ◽  
Claudio Fonda ◽  
Massimo Cadelo ◽  
Oscar Ronchi ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Lower Cranial Nerve ◽  
Lower Cranial Nerve Palsy

scholarly journals Intracavernous Internal Carotid Artery Aneurysm Presenting as Acute Diplopia: A Case Report

2020 ◽  
Vol 4 (3) ◽  
pp. 362-365
Author(s):  
Austin Brown ◽  
Health Jolliff ◽  
Douglas Poe ◽  
Michael Weinstock
Keyword(s):  
Case Report ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cranial Nerve ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm ◽  
Sixth Nerve

Introduction: Diplopia is an uncommon emergency department (ED) complaint representing only 0.1% of visits, but it has a large differential. One cause is a cranial nerve palsy, which may be from a benign or life-threatening process. Case Report: A 69-year-old female presented to the ED with two days of diplopia and dizziness. The physical exam revealed a sixth cranial nerve palsy isolated to the left eye. Imaging demonstrated an intracavernous internal carotid artery aneurysm. The patient was treated with embolization by neurointerventional radiology. Discussion: The evaluation of diplopia is initially divided into monocular, usually from a lens problem, or binocular, indicating an extraocular process. Microangiopathic disease is the most common cause of sixth nerve palsy; however, more serious etiologies may be present, such as an intracavernous internal carotid artery aneurysm, as in the patient described. Imaging modalities may include computed tomography or magnetic resonance imaging. Conclusion: Some causes of sixth nerve palsy are benign, while others will require more urgent attention, such as consideration of an intracavernous internal carotid artery aneurysm.

scholarly journals Internal Carotid Artery dissection presenting as Isolated Hypoglossal nerve palsy

2009 ◽  
Vol 8 (1) ◽  
pp. 22-25
Author(s):  
Amir Ahmad ◽  
◽  
Amir Ahmad ◽  
Philip Travis ◽  
Mark Doran ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cranial Nerve ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Cranial Nerves ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection ◽  
Cranial Nerve Palsies

Internal carotid dissection most commonly presents as headache, focal neurological deficits or stroke. Rarely it can manifest itself by causing a palsy of the lower cranial nerves (IX, X, XI, XII). The reported incidence of isolated cranial nerve palsies is rare. We report a case of an internal carotid artery dissection manifesting as isolated XII (hypoglossal) cranial nerve palsy.

scholarly journals When Nothing Goes Right: An Unexpected Tongue Deviation in Internal Carotid Artery Dissection

2019 ◽  
Vol 11 (1) ◽  
pp. 137-141 ◽  
Author(s):  
Elisa Corazza ◽  
Simone Lorenzut ◽  
Mariarosaria Valente ◽  
Gian Luigi Gigli ◽  
Giovanni Merlino
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cranial Nerve ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Intramural Hematoma ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection ◽  
Lower Cranial Nerve

Internal carotid artery dissection is a frequent cause of stroke in young people. The artery dissection and the formation of an intramural hematoma could also cause mass effect on surrounding structures, causing disorders such as cranial nerve palsies (about 12% of the cases), including XII cranial nerve. In the setting of an ischemic stroke, lower cranial nerve palsy could also be due to infratentorial ischemic lesions; however, there have been also rare reports of lower cranial nerve palsy due to supratentorial cerebral ischemic lesions. We describe a case of a 55-year-old man who presented with right internal carotid artery dissection and deviation to the left of the protruded tongue. The direction of the deviation of the protruded tongue was unexpected in this patient, because if the XII nerve palsy was due to mass effect related to the intramural hematoma of the dissected artery, a deviation to the right should have happened. Anyway, a subsequent magnetic resonance revealed also an acute ischemic lesion in the right tongue area in the primary motor cortex of the patient, providing a rare, but a fitting neuroanatomical explanation of the deviation and also providing clinical evidence of functional dominance of the crossed projections of the cortico-lingual tracts.

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