Carotid petrous segment aneurysm presenting as hypoglossal nerve palsy

Cano-Duran, Andres Jose; Reyes, Jorge Mario Sánchez; Sevilla, Maria Teresa Corbalan; Yucumá, Daniela

doi:10.1007/s00234-020-02568-9

Cited by 7 publications

(4 citation statements)

References 11 publications

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“…When there is an absence of central neurologic findings, direct cranial nerve involvement should be suspected rather than cerebral ischemia. Nevertheless, cases with manifestation limited only to the cranial nerves are considered extremely rare entities [40,41]. Aneurysms may be present in the company of other changes in the vessels such as tortuosity, distortion, and atherosclerosis [37].…”

Section: Carotid Arteriesmentioning

confidence: 99%

“…The petrous segment of the ICA starts as the artery enters the base of the skull, in the petrous part of the temporal bone [42]. Although aneurysms in this segment are mostly asymptomatic, Cano-Duran et al report a case of HN paralysis resulting from ICA dilation in its petrous part [40]. However, this should not be considered as its typical presentation.…”

Section: Carotid Arteriesmentioning

confidence: 99%

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Hypoglossal Nerve Neuropathies—Analysis of Causes and Anatomical Background

Węgiel,

Zielinska,

Głowacka

et al. 2024

Biomedicines

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The hypoglossal nerve is the last, and often neglected, cranial nerve. It is mainly responsible for motor innervation of the tongue and therefore the process of chewing and articulation. However, tumors, aneurysms, dissections, trauma, and various iatrogenic factors such as complications after surgeries, radiotherapy, or airway management can result in dysfunction. Correct differential diagnosis and suitable treatment require a thorough knowledge of the anatomical background of the region. This review presents the broad spectrum of hypoglossal neuropathies, paying particular attention to these with a compressive background. As many of these etiologies are not common and can be easily overlooked without prior preparation, it is important to have a comprehensive understanding of the special relations and characteristic traits of these medical conditions, as well as the most common concomitant disorders and morphological traits, influencing the clinical image. Due to the diverse etiology of hypoglossal neuropathies, specialists from many different medical branches might expect to encounter patients presenting such symptoms.

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Section: Carotid Arteriesmentioning

confidence: 99%

Section: Carotid Arteriesmentioning

confidence: 99%

Hypoglossal Nerve Neuropathies—Analysis of Causes and Anatomical Background

Węgiel,

Zielinska,

Głowacka

et al. 2024

Biomedicines

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“…However, in rare instances, it can be mixed with lower CN involvement causing bulbar palsy, as mentioned earlier. Aneurysms in the petrous part of the ICA can exert pressure on the hypoglossal nerve (73)(74)(75)(76). Treatment approaches for these aneurysms include endovascular techniques, surgical decompression, and conservative management.…”

Section: Hypoglossal Nerve XIImentioning

confidence: 99%

Analyzing the Relationship Between Cerebral Aneurysms and Non- Oculomotor Cranial Nerve Palsies: A Systematic Review

Badary,

Helal,

Azab

et al. 2024

Preprint

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Objectives This study aimed to investigate the association between intracerebral aneurysms and cranial nerve (CN) palsies, focusing on nerves other than the oculomotor nerve. It sought to determine the prevalence, risk factors, and clinical outcomes of these nerve palsies and compare the effectiveness of microsurgical clipping versus endovascular coiling in restoring nerve function. Methodology: Following PRISMA guidelines, a comprehensive literature search was conducted using databases like PubMed, Scopus, and Google Scholar, covering studies from 1975 to April 2024. The inclusion criteria targeted patients with non-oculomotor nerve palsies diagnosed with cerebral aneurysms. Studies published before 1975 and non-English studies were excluded. Data extraction included study design, patient characteristics, and intervention outcomes. The Joanna Briggs Institute and Newcastle-Ottawa scales were used to assess study quality. Data were synthesized narratively and statistically analysed using SPSS v27. Results The analysis included 47 patients (53.2% female, mean age 44.8 years). The internal carotid artery (ICA) was the most common aneurysm site (44.7%), and the abducent nerve (CN VI) was most frequently affected. Ruptured aneurysms had better recovery outcomes (88.9%) than unruptured ones (66.7%). Hypertension was present in 9.2%. Unilateral aneurysms were seen in 80.9%, with 76.6% having a single nerve palsy. Non-ruptured aneurysms accounted for 58.1%, and ruptured for 41.9% of associated cranial nerve palsies. Treatment included microsurgical approaches (42.6%), endovascular approaches (34%), combined approaches (6.4%), and conservative management (17%). Recovery of the palsy was observed in 75.6%, with endovascular procedures showing higher recovery (93.3%) compared to conservative treatment (28.6%). Conclusion Intracerebral aneurysms are significantly associated with non-oculomotor CN palsies. Endovascular procedures yield higher recovery rates than conservative management, particularly in ruptured aneurysms. Timely and appropriate treatment is crucial for improving nerve function recovery in these patients.

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“…In the segment of the skull base, NHN can occur due to craniocerebral trauma with a fracture of the condyle of the occipital bone. Isolated NHN due to mechanical compression by vascular structures may occur due to compression in the carotid space, aneurysms, [4] or dissections [9] of the internal carotid artery. NHN can also be caused by such a rare neoplasm as schwannoma of the HN.…”

Section: Introductionmentioning

confidence: 99%

Isolated hypoglossal nerve neuropathy in vertebral dolichoectasia: Microvascular decompression by vessel transposition with Teflon cuff

Rafaelyan¹,

Свистов²

2022

Surgical Neurology International

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Background: A clinical case of isolated unilateral hypoglossal nerve (HN) neuropathy, which spontaneously occurred from vertebral artery dolichoectasia and was cured by a new method of microvascular decompression by transposition of the vertebral artery using the Teflon cuff. Case Description: A young patient with an anamnesis of the disease for more than 4 years and complaints of a deviation of the tongue to the right and dysarthria was examined. MRI of the brain revealed compression of the medulla oblongata by an elongated, dilated, and deformed right vertebral artery. Compression of the medulla oblongata and HN was confirmed during surgery. A transposition of the vertebral artery was performed using a Teflon cuff in the ventral direction to the clivus. Three months after surgery, positive dynamics was noted in the form of regression of dysarthria and improvement of mobility and trophic language. Conclusion: Thus, isolated HN neuropathy as a result of compression by an elongated, dilated, and deformed vertebral artery is a rare neurological disease that can be successfully treated by transposition using a Teflon cuff.

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Carotid petrous segment aneurysm presenting as hypoglossal nerve palsy

Cited by 7 publications

References 11 publications

Hypoglossal Nerve Neuropathies—Analysis of Causes and Anatomical Background

Hypoglossal Nerve Neuropathies—Analysis of Causes and Anatomical Background

Analyzing the Relationship Between Cerebral Aneurysms and Non- Oculomotor Cranial Nerve Palsies: A Systematic Review

Isolated hypoglossal nerve neuropathy in vertebral dolichoectasia: Microvascular decompression by vessel transposition with Teflon cuff

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