Isolated glossopharyngeal and vagus nerve palsy due to fracture involving the jugular foramen – Report of three cases

Abstract

Paralysis of the lower cranial nerves in closed head injuries is very rare. Only sporadic cases of post-traumatic lower cranial palsy have been documented so far. We report 3 such cases who presented with lower cranial palsy due to fracture of the base of skull. They were managed conservatively with enteral feeding and steroids. Two patients recovered completely and one patient could achieve only partial recovery at one-year follow up.

Keywords

Head injury - Lower cranial nerve - Jugular foramen fracture

• References

• 1 Wani M.A., Tandon P.N., Banerji A.K., Bhatia R.. Collet-Sicard syndrome resulting from closed injury: case report. J Trauma 1991; 31: 1437-1439
• 2 Palatucci D.M.. Unilateral paralysis of cranial nerve IX to XII. JAMA 1974; 24: 229
• 3 Lo W.W.M., Solti-Bohman L.G.. High resolution CT of the jugular foramen: anatomy and vascular variants and anomalies. Radiology 1984; 150: 743-747
• 4 Rothon L.. Jugular foramen. Neurosurgery 2000; 47 suppl 267-273
• 5 Alberio N., Cultrera F., Antonelli V., Servadei F.. Isolated glossopharyngeal and vagus nerve palsy due to fracture involving the left jugular foramen. Acta Neurochir (Wien) 2005; 147: 791-794
• 6 Legros B., Fournier P., Chiaronic P., Ritz O., Fusciardi J.. Basal fracture of the skull and lower (IX, X, XI, XII) cranial nerve palsy: four case report including two fractures of the occipital condyles – a literature review. J Trauma 2000; 48: 342-348
• 7 Hashimoto T., Watanabe O., Takase M., Koniyama J., Kobota M.. Collet-Sicard syndrome after minor head trauma. Neurosurgery 1988; 23: 367-370
• 8 Shyla P.R., Manoj K.S., Sumadevi D.. An unusual aetiology of unilateral vagal palsy: a case report. Indian J Otolaryngol Head Neck Surg 2006; 58: 90-92
• 9 Schlake H.P., Goldbranner R.H., Milewski C.. et al Intra operative electromyographic monitoring of lower cranial nerve (LCN IX-XII) in skull base surgery. Clin Neurol Neurosurg 2001; 103: 72-82