Unilateral Lower Cranial Nerve Palsies due to Spontaneous Internal Carotid Artery Dissection

Jm, Klossek; Jp, Néau; Vandenmarq, P; Jp, Fontanel

doi:10.1177/000348949410300513

Cited by 6 publications

(10 citation statements)

References 11 publications

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“…There were 29 patients with idiopathic dissection of the cervical internal carotid artery and inferior cranial neuropathy, as presented in Table 1. [5][6][7][8][9][10][11][12][13][14] The proportion of males was high (86%, n = 25). The mean age was 46.6 years (28-63 years).…”

Section: Case Presentationmentioning

confidence: 99%

Successfully Treated with Endovascular Therapy against Lower Cranial Nerve Paresis Caused by Spontaneous Dissection of the Cervical Internal Carotid Artery: A Case Report

Murakami

Oda

Konno³

et al. 2016

JNET

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Objective: We report a case of spontaneous dissection of the cervical internal carotid artery.Case Presentations: A 42-year-old man presented with dysarthria, dysphagia, lingual deviation to the left, left lingual atrophy and paralyzed left soft palate. He had no history of trauma. Although brain MRI showed no abnormal findings, brain MRA, cervical MRA and angiography revealed a dissection of the cervical internal carotid artery and a dissecting aneurysm. From these findings, we diagnosed the patient with peripheral lower cranial nerve palsy caused by a spontaneous dissection of the left cervical internal carotid artery. After 1 week of conservative management, angiography demonstrated enlargement of the dissecting aneurysm. The dissection of the dissecting aneurysm was then treated with carotid artery stenting to prevent the onset of stroke. After stenting, the patient's symptoms improved gradually. Conclusion:Spontaneous cervical internal carotid artery dissection should be considered as a differential diagnosis of lower cranial nerve palsy and was successfully treated with endovascular therapy in our case.Keywords▶ spontaneous dissection of the cervical internal carotid artery, hypoglossal nerve paresis, lower cranial nerve paresis, endovascular surgery

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Section: Case Presentationmentioning

confidence: 99%

Successfully Treated with Endovascular Therapy against Lower Cranial Nerve Paresis Caused by Spontaneous Dissection of the Cervical Internal Carotid Artery: A Case Report

Murakami

Oda

Konno³

et al. 2016

JNET

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“…All cranial nerves except the olfactory may be affected (4, 26, 43, 45±52). Cranial nerve involvement can be explained by compression or stretching of the IX±XIIth cranial nerves by the expanding ICA or by interruption of the nutrient vessels (43,46,47,51,53,54). The IIIrd (occulomotor), IVth (trochlear) and VIth (abducens) cranial nerves may be compressed when dissection extends into the cavernous sinus (45,53,55).…”

Section: Symptoms and Manifestationsmentioning

confidence: 99%

Review article - Internal carotid artery dissection

Zetterling¹,

Carlström²,

Konrad

2000

Acta Neurologica Scandinavica

100

102

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The purpose of this review is to increase the awareness of internal carotid artery dissection (ICAD), a potentially serious and probably underdiagnosed condition. ICAD is a not uncommon cause of stroke in young patients. ICAD may occur spontaneously or as a result of trauma. However, the "spontaneous" dissection is often preceded by a trivial trauma. The typical patient presents with ipsilateral headache or neck pain, ipsilateral Horner's syndrome and delayed ischemic symptoms from the ipsilateral hemisphere or retina. Conventional angiography, the gold standard for diagnosis, tends to be replaced by non-invasive diagnostic methods. There are no evidence-based guidelines for therapy although anticoagulation is most commonly used. The references are selected from the Medline database for the years 1966-1997.

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“…The left carotid artery was involved in 31 cases. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][31][32][33][34][35][36] For three patients, [20][21][22] carotid dissection was bilateral but clinical signs were present only on the left. Ipsilateral Horner's syndrome was present in nineteen patients (44%).…”

Section: Clinical Findingsmentioning

confidence: 99%

“…Ipsilateral Horner's syndrome was present in nineteen patients (44%). 3,[5][6][7][8]10,11,14,15,17,19,21,36 For six patients, there were insufficient data. Pain was usually the initial manifestation and was experienced on the side of carotid dissection for 94% of patients.…”

Section: Clinical Findingsmentioning

confidence: 99%

Spontaneous Internal Carotid Artery Dissection with Lower Cranial Nerve Palsy

Guy

Deffond²,

Gabrillargues³

et al. 2001

Can. j. neurol. sci.

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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.

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Unilateral Lower Cranial Nerve Palsies due to Spontaneous Internal Carotid Artery Dissection

Cited by 6 publications

References 11 publications

Successfully Treated with Endovascular Therapy against Lower Cranial Nerve Paresis Caused by Spontaneous Dissection of the Cervical Internal Carotid Artery: A Case Report

Successfully Treated with Endovascular Therapy against Lower Cranial Nerve Paresis Caused by Spontaneous Dissection of the Cervical Internal Carotid Artery: A Case Report

Review article - Internal carotid artery dissection

Spontaneous Internal Carotid Artery Dissection with Lower Cranial Nerve Palsy

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