title: Unilateral macroglossia as sole presenting manifestation of internal carotid artery dissection.
abstract: A patient presented with acute-onset, painless, unilateral enlargement of the tongue. Steroid treatment for angioedema was ineffective, and a biopsy of an apparent mass of the tongue base showed normal tissue. Subsequent magnetic resonance imaging showed enlargement, enhancement, asymmetric T2 hyperintensity of the left half of the tongue, and dissection of the left cervical internal carotid artery (ICA) at the skull base. Unilateral enlargement of the tongue due to acute neurogenic denervation may be the sole clinical presentation of a spontaneous arterial dissection at the skull base. The hypoglossal neuropathy resulted from compression by the pseudoaneurysmal ICA dilatation or ischemia from interruption of the vasa nervorum.
authors.affiliation: Department of Neurology and Neuroscience, Weill Cornell Medical College/New York Presbyterian Hospital, 525 E 68th St, New York, NY 10065-4897, USA. pstuebge@med.cornell.edu
authors.forename: Joerg-Patrick
authors.initials: JP
authors.lastname: Stübgen
mesh_terms: D020215:Carotid Artery, Internal, Dissection / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D061228:Hypoglossal Nerve Injuries / Q000209:etiology*; D008260:Macroglossia / Q000188:drug therapy / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors