Can the hypoglossal nerve be repaired?
Repair of Hypoglossal Nerve Injury Similar to facial nerve repairs, the ideal management involves establishment of a tension-free anastomosis (Avitia & Osborne, 2008). Although this is preferably performed with end-to-end anastomosis if possible, the use of interposition grafts can be used.
What is the treatment for carotid dissection?
First-line treatment for cervical artery dissection usually is antiplatelet agents (such as aspirin) or anti-coagulation to prevent the formation of blood clots. Antiplatelet drugs such as aspirin or clopidogrel may used alone or in combination.
How long does it take for a dissected carotid artery to heal?
Once diagnosed and treated, patients with carotid artery dissection require regular follow-up and imaging studies of both carotid arteries. Healing usually takes 3-6 months, and the incidence of contralateral dissection is higher in these patients than in the general population.
How does damage to the hypoglossal nerve cause speech impairment?
Examination. Damage to the hypoglossal nerve causes paralysis of the tongue. Usually, one side of the tongue is affected, and when the person sticks out his or her tongue, it deviates or points toward the side that is damaged.
Is carotid artery dissection fatal?
Carotid dissection can lead to minor symptoms or more commonly, to severe neurologic deficits and/or death.
How does the hypoglossal nerve affect speech?
The hypoglossal nerve enables tongue movement. It controls the hyoglossus, intrinsic, genioglossus and styloglossus muscles. These muscles help you speak, swallow and move substances around in your mouth.
How do you know if you have hypoglossal nerve?
The hypoglossal nerve is tested by examining the tongue and its movements. At rest, if the nerve is injured a tongue may appear to have the appearance of a “bag of worms” (fasciculations) or wasting (atrophy). The nerve is then tested by sticking the tongue out.
Does internal carotid artery dissection cause hypoglossal nerve palsy?
However, internal carotid artery dissection induced hypoglossal nerve palsy has been seldom reported and may be difficult to diagnose in time for treatment; even angiography sometimes misses potential dissection, especially when obvious lumen geometry changing is absent.
What are the diagnostic considerations for carotid artery dissection?
At this point, the main diagnostic considerations included a cervical mass lesion within the carotid sheath, such as dissection of the carotid artery, which could cause a mass effect on the adjacent ascending sympathetic plexus or on cranial nerve XII at the base of the skull, beyond the point of emergence from the hypoglossal foramen.
What is the hypoglossal canal and what does it contain?
The hypoglossal canal contains the canalicular segment of the 12th cranial nerve, a branch of the ascending pharyngeal artery, and the anterior condylar venous plexus [ 5 ]. Previous studies suggested that an enlarged canalicular venous plexus may be responsible for the hypoglossal nerve palsy [ 5, 6 ].