Isolated Bilateral Hypoglossal Palsy Complicating a Fourth Ventricle Ependymoma Surgery.
Bilateral hypoglossal palsy
Ependymoma
Hypoglossal nucleus
Hypoglossal trigone
Medullary infarct
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
18
04
2020
accepted:
05
05
2020
pubmed:
22
5
2020
medline:
6
11
2020
entrez:
22
5
2020
Statut:
ppublish
Résumé
Isolated bilateral hypoglossal palsy is a rare condition that has never been described after surgery in the lower part of the fourth ventricle. In this article, we discuss various possible etiologies and relevant anatomy considerations of the rhomboid fossa. We describe a case of bilateral hypoglossal palsy with tongue ptosis following surgery of an ependymoma in the lower part of the fourth ventricle. Immediate postoperative imaging showed ischemic lesions in both hypoglossal nuclei, not compatible with any known arterial territory. Two etiologies could be identified: a venous medullary infarct of the medulla oblongata or direct injury of both hypoglossal nuclei due to their midline position. Finally, the patient improved progressively and returned to normal. Intraoperative neurophysiologic monitoring of hypoglossal nerves, in addition to facial nerves, should be performed for tumors in this location.
Sections du résumé
BACKGROUND
Isolated bilateral hypoglossal palsy is a rare condition that has never been described after surgery in the lower part of the fourth ventricle. In this article, we discuss various possible etiologies and relevant anatomy considerations of the rhomboid fossa.
CASE DESCRIPTION
We describe a case of bilateral hypoglossal palsy with tongue ptosis following surgery of an ependymoma in the lower part of the fourth ventricle. Immediate postoperative imaging showed ischemic lesions in both hypoglossal nuclei, not compatible with any known arterial territory. Two etiologies could be identified: a venous medullary infarct of the medulla oblongata or direct injury of both hypoglossal nuclei due to their midline position. Finally, the patient improved progressively and returned to normal.
CONCLUSIONS
Intraoperative neurophysiologic monitoring of hypoglossal nerves, in addition to facial nerves, should be performed for tumors in this location.
Identifiants
pubmed: 32437995
pii: S1878-8750(20)31006-8
doi: 10.1016/j.wneu.2020.05.046
pii:
doi:
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
1-3Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.