Presentation
Left tongue weakness.
Patient Data
Age: 70 years
Gender: Male
From the case:
Internal carotid artery dissection
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Axial T1 weighted images demonstrate a T1 hyperintense crescent (arrow) related to the tortuous distal left ICA, consistent with dissection. This is immediately adjacent to the left hypoglossal canal.
From the case:
Internal carotid artery dissection
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Axial CTA images demonstrate a tortuous distal left ICA with a curvilinear hypodense rim (long arrow), consistent with a dissection. This is located adjacent to the hypoglossal canal (short arrows).
Case Discussion
There is a distal left cervical ICA dissection, just below the skull base, in this patient presenting with left hypoglossal neuropathy. Mass effect on the adjacent hypoglossal nerve is the rare cause of this patient's neuropathy.
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