Hypoglossal nerve palsy due to internal carotid artery dissection [Neurosurgery Wiki]

This page is read only. You can view the source, but not change it. Ask your administrator if you think this is wrong.
====== Hypoglossal nerve palsy due to internal carotid artery dissection ======

[[Cranial nerve]] palsy is an infrequent manifestation of [[internal carotid artery dissection]] with the hypoglossal nerve being the most frequently affected
(< 10% of cases
((Mokri B, Silbert PL, Schievink WI, Piepgras DG. Cranial nerve
palsy in spontaneous dissection of the extracranial internal
carotid artery. Neurology 1996; 46: 356–359.))
((Sturzenegger M, Huber P. Cranial nerve palsies in spontaneous
carotid artery dissection. J Neurol Neurosurg Psychiatry 1993;
56: 1191–1199.)))
, this symptom, especially when occurring in young patients and/or in association with head or neck pain, should prompt a search for ICA dissection, ideally by MRI of the neck
((Freilinger T, Heuck A, Strupp M, Jund R. Images in vascular medicine:
Hypoglossal nerve palsy due to internal carotid artery dissection. Vasc Med. 2010
Oct;15(5):435-6. doi: 10.1177/1358863X10378789. PubMed PMID: 20926504.
)).

ICAD frequently occurs associated to focal cerebral ischemic deficits, Horner's syndrome, tinnitus or together with the involvement of other cranial nerves
((Panisset M, Eidelman BH. Multiple cranial neuropathy as a feature of internal carotid artery dissection. Stroke 1990;21:141-147.)).

The underlying mechanism of hypoglossal nerve involvement in ICAD is attributed to mechanical compression or stretching of the cranial nerve below the [[jugular foramen]] by the expanded or aneurysmal formation of the ICAD. Nevertheless, many arterial dissections have not been clearly associated with aneurysm formation. Other possible mechanism to explain the hypoglossal involvement is related to the blood supply to this cranial nerve. Ischemic injury from nutrient vessels as a result of its anatomic location adjacent to the internal carotid artery mural hematoma might occur by mechanical, embolic or hemodynamic phenomenon
((Panisset M, Eidelman BH. Multiple cranial neuropathy as a feature of internal carotid artery dissection. Stroke 1990;21:141-147.))
((Vieira VL, Pereira DC, Ribeiro VT, Leite AB, Emerique I. Spontaneous internal carotid artery dissection with paralysis of lower cranial nerves: case report [Portuguese]. Arq Neuropsiquiatr 2006;64:1047-1049.))
((Heckmann JG, Tomandl B, Duhm C, et al. Collet-Sicard syndrome due to coiling and dissection of the internal carotid artery. Cerebrovasc Dis 2000;10:487-488.))
((Urseakar MA, Singhal, BS, Konin, BL. Hypoglossal nerve palsy due to spontaneous dissection of the internal carotid artery. Clin Radiol 2000;978-979.))
((Shahab R, Savy LE, Croft CB, et. al. Isolated hipoglossal nerve palsy due to internal carotid artery dissection. J Laryngol Otol 2001;115:587-589.))
((Lieschke GJ, Davis S, Tress BM, et al. Spontaneous internal carotid artery dissection presenting as hypoglossal nerve palsy. Stroke 1988;19:1151-1155.)).        

===== Case reports =====
Transient left [[hypoglossal nerve palsy]] caused by mechanic compression from intramural hematoma in higher extracranial portion of [[internal carotid artery dissection]] confirmed in MRI and CT scans
((Mes M, Palczewski P, Szczudlik P, Łusakowska A, Maj E, Gawel M. Hypoglossal
nerve palsy as an isolated syndrome of internal carotid artery dissection: A
review of the literature and a case report. Neurol Neurochir Pol. 2018 Jul 6.
pii: S0028-3843(17)30477-2. doi: 10.1016/j.pjnns.2018.06.006. [Epub ahead of
print] PubMed PMID: 30082078.
)).
----
Isolated [[hypoglossal nerve palsy]] due to [[internal carotid artery dissection]]
((Joshi P, Bourke D. Isolated hypoglossal nerve palsy due to internal carotid
artery dissection. Pract Neurol. 2017 Jun;17(3):233-234. doi:
10.1136/practneurol-2017-001617. Epub 2017 Mar 20. PubMed PMID: 28320781.
)).
----
Hypoglossal Nerve Palsy Due to Internal Carotid Artery Dissection
((Journals.sagepub.com. (2018). Hypoglossal Nerve Palsy Due to Internal Carotid Artery Dissection - William Allingham, Vinodh Devakumar, Amit Herwadkar, Martin Punter, 2017. [online] Available at: http://journals.sagepub.com/doi/abs/10.1177/1941874417736711 [Accessed 15 Aug. 2018].)).
----
Unilateral isolated hypoglossal nerve palsy associated with internal carotid artery dissection
((Riancho J, Infante J, Mateo JI, Berciano J, Agea L. Unilateral isolated
hypoglossal nerve palsy associated with internal carotid artery dissection. J
Neurol Neurosurg Psychiatry. 2013 Jun;84(6):706. doi: 10.1136/jnnp-2013-304923.
Epub 2013 Mar 7. PubMed PMID: 23471209.
)).
----

In 2012 A 57-year-old man presented with dysarthria and left-sided headache lasting 4 days. Neurologic examination revealed deviation of the tongue to the left. MRI demonstrated the left carotid artery
dissection and its anatomic juxtaposition with the left hypoglossal nerve. Tongue
deviation returned to normal after 4 weeks of treatment with aspirin
((Okunomiya T, Kageyama T, Suenaga T. Teaching NeuroImages: isolated hypoglossal
nerve palsy due to internal carotid artery dissection. Neurology. 2012 Jul
24;79(4):e37. doi: 10.1212/WNL.0b013e3182604506. PubMed PMID: 22826549.
)).
----
In 2009 Hypoglossal nerve palsy as the sole manifestation of spontaneous internal carotid artery dissection
((Marin LF, Bichuetti DB, Felício AC, dos Santos WA, de Oliveira FF, Morita ME, 
Avelar WM, Braga-Neto P, Lima EC, Martins RJ. Hypoglossal nerve palsy as the sole
manifestation of spontaneous internal carotid artery dissection. Arq
Neuropsiquiatr. 2009 Mar;67(1):107-8. PubMed PMID: 19330223.
)).
----
A 43-year-old man presented with a 3-week history of mild dysarthria. There was no history of craniocervical trauma. The physical examination revealed an isolated left hypoglossal nerve paresis. Magnetic resonance imaging and angiography findings were consistent with a left skull base ICAD. The patient was successfully treated with anticoagulation therapy. The current rate of cranial nerve involvement is estimated at 10% of all ICADs. This is the second report of isolated hypoglossal nerve palsy without hemicrania in a case of atraumatic ICAD
((Lindsay FW, Mullin D, Keefe MA. Subacute hypoglossal nerve paresis with
internal carotid artery dissection. Laryngoscope. 2003 Sep;113(9):1530-3. PubMed 
PMID: 12972929.
)).
----
In 2001 Isolated hypoglossal nerve palsy due to internal carotid artery dissection
((Shahab R, Savy LE, Croft CB, Hung T. Isolated hypoglossal nerve palsy due to
internal carotid artery dissection. J Laryngol Otol. 2001 Jul;115(7):587-9.
PubMed PMID: 11485598.
)).
----
In 1998 Boukobza et al., published a case of unilateral XIIth nerve palsy due to the dissection of the internal carotid artery. They described the clinical and radiological features.
In this patient, cranial nerve palsy is probably the result of compression by an enlarging carotid artery due to mural hematoma. Diagnosis is discussed with emphasis on magnetic resonance imaging findings. Magnetic resonance imaging is also useful for follow-up of arterial lesions
((Boukobza M, Ast G, Reizine D, Merland JJ. Internal carotid artery dissection
causes hypoglossal nerve palsy: CT, MRI, and angiographic findings. J
Neuroimaging. 1998 Oct;8(4):244-6. PubMed PMID: 9780859.
)).

===== References =====