All Journals from Aram Baghomian
Abstract
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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We describe the case of a 46-year-old female who presented with recurrent episodes of cerebrovascular events. She had an unremarkable family history and no risk factors for stroke, apart from smoking. A transthoracic echocardiogram with ‘bubble’ contrast was normal. However transoesophageal echocardiography demonstrated an aneurysm of the membranous part of the ventricular septum, representing the likely source of thrombo-embolisation. This case highlights the need for a systematic and rigorous approach to the investigation of young patients with stroke.
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