Volume 21, Issue 2 pp. e177-e179

Idiopathic Hypoglossal Nerve Laceration Detected by High-Resolution Three-Dimensional Constructive Interference in Steady State Magnetic Resonance Imaging

Ken Sakushima MD, MPH

Ken Sakushima MD, MPH

From the Department of Neurology, Hokkaido University Graduate School of Medicine, Sapporo, Japan (KS, STA, MN, IY, HS); and Department of Radiology, Hokkaido University Hospital, Sapporo, Japan (ST).

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Satoshi Terae MD, PhD

Satoshi Terae MD, PhD

From the Department of Neurology, Hokkaido University Graduate School of Medicine, Sapporo, Japan (KS, STA, MN, IY, HS); and Department of Radiology, Hokkaido University Hospital, Sapporo, Japan (ST).

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Sachiko Tsuji-Akimoto MD, PhD

Sachiko Tsuji-Akimoto MD, PhD

From the Department of Neurology, Hokkaido University Graduate School of Medicine, Sapporo, Japan (KS, STA, MN, IY, HS); and Department of Radiology, Hokkaido University Hospital, Sapporo, Japan (ST).

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Masaaki Niino MD, PhD

Masaaki Niino MD, PhD

From the Department of Neurology, Hokkaido University Graduate School of Medicine, Sapporo, Japan (KS, STA, MN, IY, HS); and Department of Radiology, Hokkaido University Hospital, Sapporo, Japan (ST).

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Ichiro Yabe MD, PhD

Ichiro Yabe MD, PhD

From the Department of Neurology, Hokkaido University Graduate School of Medicine, Sapporo, Japan (KS, STA, MN, IY, HS); and Department of Radiology, Hokkaido University Hospital, Sapporo, Japan (ST).

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Hidenao Sasaki MD, PhD

Hidenao Sasaki MD, PhD

From the Department of Neurology, Hokkaido University Graduate School of Medicine, Sapporo, Japan (KS, STA, MN, IY, HS); and Department of Radiology, Hokkaido University Hospital, Sapporo, Japan (ST).

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First published: 24 March 2011
Citations: 5
Correspondence: Address correspondence to Ichiro Yabe, MD, PhD, Department of Neurology, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo 060-8638 Japan. E-mail: [email protected].

Financial Disclosure: None.

Conflict of Interest: None.

J Neuroimaging 2011;21:e177-e179.

ABSTRACT

A 55-year-old man presented with acute onset dysarthria caused by left hypoglossal palsy. He had neither surgery nor injury prior to the onset of his symptoms. We detected no abnormalities with conventional magnetic resonance imaging (MRI) except for a slight gadolinium enhancement of the left hypoglossal nerve. Three-dimensional constructive interference in steady state MRI (CISS MRI) showed curling and thickening of the left hypoglossal nerve and fluid accumulation in the hypoglossal nerve canal. A systemic survey found no malignancies. After 8 months, sustained left hypoglossal palsy and no change in the MRI led to the diagnosis of idiopathic hypoglossal nerve laceration with evulsion. In such patients, the cause of the defect is not always apparent and 3-dimensional CISS MRI may resolve this issue.

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