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Case Reports
. 2021 May 3;13(5):e14819.
doi: 10.7759/cureus.14819.

Isolated Unilateral Hypoglossal Nerve Palsy Caused by Internal Carotid Artery Loop

Murat Dokdok  1 , Selçuk Göçmen  2 , Serdar Kahraman  2 , Yaşar Kütükçü  3
Affiliations
Case Reports

Isolated Unilateral Hypoglossal Nerve Palsy Caused by Internal Carotid Artery Loop

Murat Dokdok et al. Cureus. .

Abstract

Isolated unilateral hypoglossal nerve (HN) palsy caused by vascular compression is a rare condition. We report a case of a 42-year-old male, presenting with tongue paresis and unilateral atrophy of the tongue due to an internal carotid artery (ICA) loop. The compression of HN by ICA loop and concomitant wall irregularities of the loop segment were observed in magnetic resonance imaging and digital subtraction angiography (DSA). The patient was managed with antithrombotic without the need of any further intervention. To our best knowledge, this is the first reported case of isolated compressive neuropathy of the HN caused by loop of the ICA. Here, the clinical presentation, etiology, and management of isolated HN palsy caused by vascular lesions are discussed along with the relevant literature.

Keywords: carotid artery dissection; cerebral angiography; internal carotid artery loop; isolated hypoglossal nerve palsy; vascular compression.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Atrophy on the left side of the tongue (open arrow) that deviated toward the paralyzed site
Figure 2
Figure 2. The axial raw image of time-of-flight magnetic resonance angiography showing vascular loop (open arrow) in the outlet portion of left hypoglossal canal
Figure 3
Figure 3. Digital subtraction angiography displaying type 3 loop of the internal carotid artery with wall irregularities (open arrow)
Figure 4
Figure 4. Anatomic relationship of internal carotid artery (ICA) and vertebral artery (VA) with hypoglossal nerve (HN)
1: HN perimedullary segment, 2: HN cisternal segment, 3: HN hypoglossal canal segment, 4: HN carotid space segment, 5: HN sublingual segment.
See this image and copyright information in PMC

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