Surgical Treatment of Spontaneous Internal Carotid Artery Dissection with Abducent Nerve Palsy: Case Report and Review of Literature

2019 ◽  
Vol 125 ◽  
pp. 10-14
Author(s):  
Shimpei Tsuboki ◽  
Takayuki Kawano ◽  
Yuki Ohmori ◽  
Toshihiro Amadatsu ◽  
Akitake Mukasa
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Review Of Literature ◽  
Internal Carotid Artery Dissection ◽  
Abducent Nerve Palsy ◽  
Abducent Nerve

scholarly journals Isolated oculomotor nerve palsy inspontaneous internal carotid artery dissection: case report

2003 ◽  
Vol 61 (3A) ◽  
pp. 668-670 ◽  
Author(s):  
Cynthia Resende Campos ◽  
Ayrton Roberto Massaro ◽  
Milberto Scaff
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Carotid Artery Dissection ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection ◽  
The Third

Partial oculosympathetic palsy followed by ischemic manifestations in brain or retina are the main symptoms of extracranial internal carotid artery (ICA) dissection. Unusually, cranial nerves may be affected. Isolated oculomotor nerve palsy is found only rarely. CASE: We present a 50-year-old nondiabetic man who experienced acute onset of right occipital headache which spread to the right retro-orbital region. Five days later he noticed diplopia and right blurred vision sensation. Neurologic examination disclosed only impaired adduction and upward gaze of right eye, slight ipsilateral pupillary dilatation, without ptosis. Brain MRI was normal. Angiography showed right internal carotid artery dissection with forward occlusion to the base of the skull. Intravenous heparin followed by warfarin was prescribed. The headache and the oculomotor nerve deficit gradually resolved in the next three weeks. DISCUSSION: Isolated oculomotor nerve palsy is underrecognized as a clinical presentation of extracranial ICA dissection. If the angiographic evaluation is incomplete without careful study of extracranial arteries, misdiagnosis may lead to failure to initiate early treatment to prevent thromboembolic complications. For this reason we draw attention to the need for careful evaluation of cervical arteries in patients with oculomotor nerve palsy. Mechanical compression or stretching of the third nerve are possible mechanisms, but the direct impairment of the blood supply to the third nerve seems to be the most plausible explanation.

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.

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