Cargando…
Acute Tongue Swelling as a Still Unexpected Manifestation of Internal Carotid Artery Dissection: A Case Report
The diagnosis of internal carotid artery dissection (ICAD) at the stage of local signs is essential in the prevention of the life-treating cerebral complication; however, making this diagnosis has significant difficulties. We present the case of a 36-year-old female with left ICAD with asymmetric le...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10137044/ https://www.ncbi.nlm.nih.gov/pubmed/37190568 http://dx.doi.org/10.3390/brainsci13040603 |
_version_ | 1785032364531908608 |
---|---|
author | Pawlukowska, Wioletta Mross, Krystian Jankowska, Marta Zwarzany, Łukasz Poncyljusz, Wojciech Masztalewicz, Marta |
author_facet | Pawlukowska, Wioletta Mross, Krystian Jankowska, Marta Zwarzany, Łukasz Poncyljusz, Wojciech Masztalewicz, Marta |
author_sort | Pawlukowska, Wioletta |
collection | PubMed |
description | The diagnosis of internal carotid artery dissection (ICAD) at the stage of local signs is essential in the prevention of the life-treating cerebral complication; however, making this diagnosis has significant difficulties. We present the case of a 36-year-old female with left ICAD with asymmetric left-sided tongue swelling as an unusual and still unexpected symptom. The patient’s complaints at admission were left-sided numbness of the tongue and swallowing difficulties but its movements were intact. Despite the provided treatment for suspected angioedema, no improvement was noted. Additional examination revealed left-sided tongue weakness, ipsilateral soft palate palsy, paralysis and reduced tension of the left vocal fold, and left-sided Horner’s syndrome. Another suspected diagnosis was a dysfunction of the IX, X, and XII cranial nerves. A head MRI revealed an intramural hematoma of the left internal carotid artery. The radiologists suggested ICAD. The angio-MRI of the head arteries confirmed this diagnosis. The patient received dual antiplatelet therapy. The neuro-logopaedic therapy was also implemented. Currently, the patient’s symptoms are gradually improving with significantly better results on follow-up neuroimaging. Among the possible local symptoms of ICAD, proper attention should be paid to asymmetric swelling of the tongue as an atypical manifestation of damage to the hypoglossal nerve. |
format | Online Article Text |
id | pubmed-10137044 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-101370442023-04-28 Acute Tongue Swelling as a Still Unexpected Manifestation of Internal Carotid Artery Dissection: A Case Report Pawlukowska, Wioletta Mross, Krystian Jankowska, Marta Zwarzany, Łukasz Poncyljusz, Wojciech Masztalewicz, Marta Brain Sci Case Report The diagnosis of internal carotid artery dissection (ICAD) at the stage of local signs is essential in the prevention of the life-treating cerebral complication; however, making this diagnosis has significant difficulties. We present the case of a 36-year-old female with left ICAD with asymmetric left-sided tongue swelling as an unusual and still unexpected symptom. The patient’s complaints at admission were left-sided numbness of the tongue and swallowing difficulties but its movements were intact. Despite the provided treatment for suspected angioedema, no improvement was noted. Additional examination revealed left-sided tongue weakness, ipsilateral soft palate palsy, paralysis and reduced tension of the left vocal fold, and left-sided Horner’s syndrome. Another suspected diagnosis was a dysfunction of the IX, X, and XII cranial nerves. A head MRI revealed an intramural hematoma of the left internal carotid artery. The radiologists suggested ICAD. The angio-MRI of the head arteries confirmed this diagnosis. The patient received dual antiplatelet therapy. The neuro-logopaedic therapy was also implemented. Currently, the patient’s symptoms are gradually improving with significantly better results on follow-up neuroimaging. Among the possible local symptoms of ICAD, proper attention should be paid to asymmetric swelling of the tongue as an atypical manifestation of damage to the hypoglossal nerve. MDPI 2023-04-02 /pmc/articles/PMC10137044/ /pubmed/37190568 http://dx.doi.org/10.3390/brainsci13040603 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Pawlukowska, Wioletta Mross, Krystian Jankowska, Marta Zwarzany, Łukasz Poncyljusz, Wojciech Masztalewicz, Marta Acute Tongue Swelling as a Still Unexpected Manifestation of Internal Carotid Artery Dissection: A Case Report |
title | Acute Tongue Swelling as a Still Unexpected Manifestation of Internal Carotid Artery Dissection: A Case Report |
title_full | Acute Tongue Swelling as a Still Unexpected Manifestation of Internal Carotid Artery Dissection: A Case Report |
title_fullStr | Acute Tongue Swelling as a Still Unexpected Manifestation of Internal Carotid Artery Dissection: A Case Report |
title_full_unstemmed | Acute Tongue Swelling as a Still Unexpected Manifestation of Internal Carotid Artery Dissection: A Case Report |
title_short | Acute Tongue Swelling as a Still Unexpected Manifestation of Internal Carotid Artery Dissection: A Case Report |
title_sort | acute tongue swelling as a still unexpected manifestation of internal carotid artery dissection: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10137044/ https://www.ncbi.nlm.nih.gov/pubmed/37190568 http://dx.doi.org/10.3390/brainsci13040603 |
work_keys_str_mv | AT pawlukowskawioletta acutetongueswellingasastillunexpectedmanifestationofinternalcarotidarterydissectionacasereport AT mrosskrystian acutetongueswellingasastillunexpectedmanifestationofinternalcarotidarterydissectionacasereport AT jankowskamarta acutetongueswellingasastillunexpectedmanifestationofinternalcarotidarterydissectionacasereport AT zwarzanyłukasz acutetongueswellingasastillunexpectedmanifestationofinternalcarotidarterydissectionacasereport AT poncyljuszwojciech acutetongueswellingasastillunexpectedmanifestationofinternalcarotidarterydissectionacasereport AT masztalewiczmarta acutetongueswellingasastillunexpectedmanifestationofinternalcarotidarterydissectionacasereport |