Abstract
Aneurysm in the petrous segment of the internal carotid artery is extremely rare, and symptoms are usually derived from compression of neighbor structures such as nerve palsies. Clinical symptoms can be nonspecific and imaging findings are complex, making the diagnosis of this kind of aneurysms extremely challenging. CT angiography is the best diagnostic tool, and treatment options include surgical and endovascular approaches, the latest being preferred. We report an extremely rare case of an aneurysm in the petrous apex presenting with hypoglossal nerve palsy. We document the aneurysm through CT and confirm it using angiography. We also describe the satisfactory management of this rare case. To the best of our knowledge this an extremely rare aneurism presenting with hypoglossal nerve palsy, in which successful interventional management was achieved through a specific and prompt diagnosis.
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References
Jindal G, Miller T, Raghavan P, Gandhi D (2017) Imaging Evaluation and Treatment of Vascular Lesions at the Skull Base. Radiol Clin N Am 55:151–166
Hazarika P, Sahota JS, Nayak DR, George S (1993) Congenital internal carotid artery aneurysm. Int J Pediatr Otorhinolaryngol 28:63–68
Liu JK, Gottfried ON, Amini A, Couldwell WT (2004) Aneurysms of the petrous internal carotid artery: anatomy, origins, and treatment. Neurosurg Focus 17(5):E13
Murai Y, Shirokane K, Kitamura T, Tateyama K, Matano F, Mizunari T, Morita A (2020) Petrous internal carotid artery aneurysms: A systematic review. J Nippon Med Sch 87(4):172–183
Okunomiya T, Kageyama T, Suenaga T (2012) Teaching NeuroImages: Isolated hypoglossal nerve palsy due to internal carotid artery dissection. Neurology. 79(4):e37
Riancho J, Infante J, Mateo JI, Berciano J, Agea L (2013) Unilateral isolated hypoglossal nerve palsy associated with internal carotid artery dissection. J Neurol Neurosurg Psychiatry 84(6):706
Gross BA, Moon K, Ducruet AF, Albuquerque FC (2017) A rare but morbid neurosurgical target: petrous aneurysms and their endovascular management in the stent/flow diverter era. J Neurointerv Surg 9(4):381–383
Chapman PR, Shah R, Cure JK, Bag AK (2011) Petrous apex lesions: Pictorial review. Am J Roentgenol 196(3):26–37
Razek AA, Huang BY (2012) Lesions of the Petrous Apex: Classification and Findings at CT and MR Imaging. Radiographics. 32:151–173
Aiken AH (2012) Diagnostic imaging: Head and neck, 2nd edition. Head & Neck. (34): 1362.
Schmalfuss IM (2012) Malignant Lesions of the Central and Posterior Skull Base. In: Hermans R (ed) Head and neck cancer imaging. Springer, Berlin, pp 261–290
George M, Ghali Z, Binning M (2019) Flow Diversion for the Treatment of Petrous Internal Carotid Artery Aneurysms. Asian J Neurosurg 14:1058–1062
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Cano-Duran, A.J., Sanchez Reyes, J.M., Corbalan Sevilla, M.T. et al. Carotid petrous segment aneurysm presenting as hypoglossal nerve palsy. Neuroradiology 63, 447–450 (2021). https://doi.org/10.1007/s00234-020-02568-9
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DOI: https://doi.org/10.1007/s00234-020-02568-9