Isolated hypoglossal nerve palsy due to internal carotid artery dissection

Antiplatelet and anticoagulant treatments appear equally effective. 2 The more common manifestations of internal carotid artery dissection are headache, neck pain, ipsilateral oculosympathetic paresis (Horner's syndrome), and transient cerebral and ocular ischaemia. 1 The hypoglossal nerve orig...

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Bibliographic Details
Published inPractical neurology Vol. 17; no. 3; pp. 233 - 234
Main Authors Joshi, Purwa, Bourke, David
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group LTD 01.06.2017
Subjects
Carotid arteries
Dissection
Headaches
Neurological disorders
Thrombosis
Veins & arteries
Clinical neurology
Neuroanatomy
Cerebrovascular disease
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Summary:Antiplatelet and anticoagulant treatments appear equally effective. 2 The more common manifestations of internal carotid artery dissection are headache, neck pain, ipsilateral oculosympathetic paresis (Horner's syndrome), and transient cerebral and ocular ischaemia. 1 The hypoglossal nerve originates from the hypoglossal (XIIth cranial nerve) nucleus in the medial medulla, exits the skull via the hypoglossal canal, and passes between the internal jugular vein and internal carotid artery at the skull base. 3 At this point, it is vulnerable to compression from a high internal carotid artery dissection-mural thrombus causes eccentric expansion of the arterial wall-compressing the nerve. 4 The cervical sympathetic trunk and cranial nerves IX, X and XI also lie in close proximity to the internal carotid artery at this level; a dissection can also compress these ( figure 2 ).
Bibliography:SourceType-Other Sources-1
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ISSN:1474-7758
1474-7766
DOI:10.1136/practneurol-2017-001617