N. hypoglossus-parese ved a. carotis interna-dissektion

This is a case report of a 38-year-old, previously healthy man who was initially seen at an otorhinolaryngological department due to "swelling" of his tongue. Further history revealed four days of severe, non-specific headache and lisping. Two weeks prior to hospital admission he had seen a chiropractor due to neck pain. On examination at the hospital there was isolated left hypoglossal nerve palsy. He was urgently referred to a department of neurology. Magnetic resonance angiography showed internal carotid artery dissection. Aspirin and clopidogrel were commenced. At the three months follow-up examination he had recovered completely symptom wise and a renewed magnetic resonance imaging was normal.