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...

Descripción completa

Detalles Bibliográficos
Autores principales: Pawlukowska, Wioletta, Mross, Krystian, Jankowska, Marta, Zwarzany, Łukasz, Poncyljusz, Wojciech, Masztalewicz, Marta
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