Isolated glossopharyngeal and vagus nerves palsy due to fracture involving the left jugular foramen.
This report describes a case of delayed post-traumatic glossopharyngeal and vagus nerves palsy (i.e. dysphonia and swallowing dysfunction). A high resolution CT study of the cranial base detected a fracture rim encroaching on the left jugular foramen. Treatment consisted in supportive measures with incomplete recovery during a one-year follow-up period. Lower cranial nerves palsies after head trauma are rare and, should they occur, a thorough investigation in search of posterior cranial base and cranio-cervical lesions is warranted. The presumptive mechanism in our case is a fracture-related oedema and ischemic damage to the nerves leading to the delayed occurrence of the palsy.
Alberio
N
N
Division of Neurosurgery/Neurotraumatology, WHO Neurotrauma Collaborating Centre, Ospedale M.Bufalini (OMB), Cesena, Italy. n.alberio@tin.it
Cultrera
F
F
Antonelli
V
V
Servadei
F
F
D000293:Adolescent; D003680:Deglutition Disorders / Q000209:etiology*; D003937:Diagnosis, Differential; D020435:Glossopharyngeal Nerve Diseases / Q000209:etiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D019291:Skull Base / Q000293:injuries*; D012887:Skull Fractures / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D020421:Vagus Nerve Diseases / Q000209:etiology*; D014826:Vocal Cord Paralysis / Q000209:etiology*; D014832:Voice Disorders / Q000209:etiology*