Carotid petrous segment aneurysm presenting as hypoglossal nerve palsy
- PDF / 594,757 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 42 Downloads / 204 Views
SHORT REPORT
Carotid petrous segment aneurysm presenting as hypoglossal nerve palsy Andres Jose Cano-Duran 1 & Jorge Mario Sanchez Reyes 1 & Maria Teresa Corbalan Sevilla 1 & Daniela Yucumá 1,2 Received: 31 July 2020 / Accepted: 23 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Aneurysm in the petrous segment of the internal carotid artery is extremely rare, and symptoms are usually derived from compression of neighbor structures such as nerve palsies. Clinical symptoms can be nonspecific and imaging findings are complex, making the diagnosis of this kind of aneurysms extremely challenging. CT angiography is the best diagnostic tool, and treatment options include surgical and endovascular approaches, the latest being preferred. We report an extremely rare case of an aneurysm in the petrous apex presenting with hypoglossal nerve palsy. We document the aneurysm through CT and confirm it using angiography. We also describe the satisfactory management of this rare case. To the best of our knowledge this an extremely rare aneurism presenting with hypoglossal nerve palsy, in which successful interventional management was achieved through a specific and prompt diagnosis. Keywords Aneurysm . Complications . Carotid artery, internal . Diagnostic imaging . Hypoglossal nerve palsy
Case presentation A 25-year-old male presented to the Emergency Department with twenty-four hours history of tongue dysaesthesia and severe, progressive, left-sided headache, which was unresponsive to analgesics and non-steroidal anti-inflammatory drugs. The headache had a sudden onset two months prior to consulting, and progressively increased. Physical examination revealed palsy of the left hypoglossal nerve, and the physical exam was otherwise unremarkable. Past medical history was significant for two episodes of spontaneous pneumothorax and a remote history of heart arrhythmia. * Daniela Yucumá [email protected] Andres Jose Cano-Duran [email protected] Jorge Mario Sanchez Reyes [email protected] Maria Teresa Corbalan Sevilla [email protected] 1
Hospital Universitario de Getafe, ES 28905 Getafe, Madrid, Spain
2
Pontificia Universidad Javeriana, Bogotá, Colombia
Family medical history included a treated cerebral aneurysmal in his mother and two strokes on his grandfather. An MRI was performed, revealing a complex expansive mass of the left petrous internal carotid artery (ICA) canal. The mass had a markedly heterogeneous signal, with predominantly high signal on T1-weighted images and low signal on T2-weighted images (Fig. 1). Contrast-enhanced MRI and MRI angiographic sequences showed ovoid dilatation of the left ICA petrous segment, which was communicated with the mass described previously. A CT was later performed to better depict the aneurysmal nature of the lesion on the left ICA petrous segment (Fig. 2). The aneurysm measured 4 × 3 × 3 cm and associated extensive benign bony remodeling around its borders. Curvilinear calcifications of the vessel wall and aneurysmal near-complet
Data Loading...
