A reminder for a very rare entity: massive tongue swelling after posterior fossa surgery.

Abstract

OBJECTIVE:

The purpose of this study is to report a case of presumably neurogenic macroglossia that occurred after surgical trapping of a vertebral artery (VA)-posteroinferior cerebellar artery aneurysm, and to analyze its potential pathogenesis.

CLINICAL PRESENTATION:

A 53-year-old woman who suffered from headaches and intermittent loss of consciousness but without evidence of subarachnoid hemorrhage was admitted. Magnetic resonance imaging and angiography showed an irregular aneurysm in the fourth segment of a left dominant VA.

INTERVENTION:

Surgical treatment was indicated after discussion with the neuroradiology team. During surgery, in the prone position the aneurysm ruptured. The patient became hemodynamically instable. On the first postoperative day, macroglossia appeared and remained for 3 weeks until spontaneous regression.

CONCLUSION:

Macroglossia is a rare complication following neurosurgical procedures with very few cases reported so far. It has been attributed to the sitting position and venous flow congestion. We illustrate a case of macroglossia, which occurred following surgery in the prone position. Its etiology remains speculative, but a neurogenic explanation seems most plausible.

• Authors: Yassine El Hassani, Ana Paula Narata, Vitor Mendes Pereira, Carlo Schaller
• Journal: Journal of neurological surgery. Part A, Central European neurosurgery (J Neurol Surg A Cent Eur Neurosurg) Vol. 73 Issue 3 Pg. 171-4 (May 2012) ISSN: 2193-6323 [Electronic] Germany
• PMID: 22628082 (Publication Type: Case Reports, Journal Article)
• Copyright: Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Chemical References

• Anti-Inflammatory Agents
• Dexamethasone

Topics

• Aneurysm, Ruptured (surgery)
• Anti-Inflammatory Agents (therapeutic use)
• Cerebral Angiography
• Cranial Fossa, Posterior (surgery)
• Craniotomy
• Dexamethasone (therapeutic use)
• Female
• Hemodynamics (physiology)
• Humans
• Laminectomy
• Macroglossia (etiology, therapy)
• Magnetic Resonance Angiography
• Magnetic Resonance Imaging
• Middle Aged
• Neurosurgical Procedures (adverse effects)
• Postoperative Complications (therapy)
• Posture (physiology)
• Vertebral Artery Dissection (surgery)