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Macroglossia associated with brainstem injury.

AbstractBACKGROUND:
Macroglossia has been reported in patients undergoing posterior fossa neurosurgical procedures and is thought to be as a result of venous engorgement from intubation or mechanical positioning during these prolonged procedures.
METHODS:
We report three patients who developed macroglossia and dysautonomia of central neurogenic origin following brainstem injury.
RESULTS:
The three patients developed macroglossia and dysautonomia with wide hemodynamic fluctuations in the setting of posterior fossa injury of the lower brainstem structures, necessitating tracheostomy placement. Macroglossia was managed with dexamethasone and there was complete resolution of dysautonomia while treated with beta-blockers and gabapentin.
CONCLUSIONS:
Neurointensivists should be aware of macroglossia with dysautonomia complicating brainstem injury, which may have perilous consequences in the setting of cerebral edema or intracranial hypertension.
AuthorsIfeanyi Iwuchukwu, Agnieszka Ardelt, Wilson Cueva, Rwoof Reshi, Fernando Goldenberg, Jeffrey Frank
JournalNeurocritical care (Neurocrit Care) Vol. 20 Issue 1 Pg. 106-10 (Feb 2014) ISSN: 1556-0961 [Electronic] United States
PMID24002892 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Adrenergic beta-Antagonists
  • Amines
  • Anti-Inflammatory Agents
  • Calcium Channel Blockers
  • Cyclohexanecarboxylic Acids
  • gamma-Aminobutyric Acid
  • Gabapentin
  • Dexamethasone
Topics
  • Adolescent
  • Adrenergic beta-Antagonists (therapeutic use)
  • Aged
  • Amines (therapeutic use)
  • Anti-Inflammatory Agents (therapeutic use)
  • Brain Injuries (complications, etiology)
  • Brain Stem (injuries)
  • Calcium Channel Blockers (therapeutic use)
  • Cranial Fossa, Posterior (injuries)
  • Cyclohexanecarboxylic Acids (therapeutic use)
  • Dexamethasone (therapeutic use)
  • Female
  • Gabapentin
  • Humans
  • Macroglossia (drug therapy, etiology, surgery)
  • Male
  • Middle Aged
  • Primary Dysautonomias (drug therapy, etiology)
  • Tracheostomy (methods)
  • Treatment Outcome
  • gamma-Aminobutyric Acid (therapeutic use)

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