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Multiple Cranial Neuropathy as a Feature of Internal Carotid Artery Dissection
Stroke 21:141-147, Panisset,M.&Eidelman,B.H., 1990
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Article Abstract
The traditional presentation of spontaneous internal carotid artery dissection includes ipsilateral hemocranial headache,oculosympathetic paresis,and contralateral focal cerebral ischemic deficits.However,we describe two cases with multiple cranial nerve involvement ipsilateral to the dissection as the principal feature.The first patient,a 36-year-old man,had involvement of the 9th,10th,11th,and 12th cranial nerves.The second case was a 53-year-old man with abnormalities of the 5th,7th,9th, 10th,and 12th cranial nerves.In both,magnetic resonance imaging revealed a ring-like area of abnormal signal intensity surrounding the carotid artery at the skull base.Carotid angiography was consistent with the suggestion of dissection on the magnetic resonance studies in both cases.The patients recovered without anticoagulation.Internal carotid artery dissection may thus present with multiple cranial nerve palsies,which could be mistaken for an infiltrating tumor of the skull base.Magnetic resonance imaging is useful in identifying the condition.
 
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arterial dissection
arterial dissection,carotid
carotid angiogram
cranial nerve palsies
cranial neuropathy,multiple
facial nerve
facial nerve palsy
facial weakness
glossopharyngeal nerve
hypoglossal nerve paralysis
MRI
MRI,abnormal
transient ischemic attack
trigeminal nerve
trigeminal neuropathy
vagal neuropathy

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