Isolated Unilateral Vagus Nerve Palsy Secondary to Trauma

A 41 year old man presented to emergency service with loss of consciousness lasting 20 minutes after a strike of a wood piece to right side of his face. Shortly after admission, he developed difficulty in swallowing. On admission, he was alert and had normal vital findings. There was no motor, sensorial, and cerebellar deficit. Deviation of the uvula to left side and pharyngeal reflex loss at the right side was obvious. The right vocal cord was paralyzed. Other cranial nerves were intact on examination. The patient’s cranial computed tomography (CT), CT-angiogram, cranial and neck magnetic resonance (MR) imaging, MR-angiogram, and cervical and lung X-ray were normal. We evaluated this case with isolated unilateral vagus nerve palsy (VNP) secondary to trauma at the emergency department. Our case illustrated that trauma can cause isolated VNP with the absence of abnormal findings on imaging modalities.

Travmaya Sekonder Izole Tek Taraflý Nervus Vagus Yaralanmasý

Yüzünün sað tarafýna tahta parçasý çarptýktan sonra 20 dakika bilinç kaybý geliþen 41 yaþýnda erkek hasta acil servise baþvurdu. Kabulden kýsa bir sure sonra hastada yutma güçlüðü geliþti. Kabülde hasta alertti ve vital bulgularý normaldi, motor, sensorial ve serebeller defisiti yoktu. Uvula sola deviyeydi ve sað tarafta belirgin farengeal reflex kaybý vardý. Sað vokal kortlarda paralizi mevcuttu. Diðer kranial sinir muayeneleri intaktý. Hastanýn beyin tomoðrafisi (BT), BT anjiyogramý, beyin ve boyun magnetic resonance (MR) bulgularý, MR anjiyogramý, servikal ve akciger grafileri normaldi. Biz acil serviste travmaya sekonder izole tek taraflý nervus vagus yarlanmasýný deðerlendirdik. Bizim vakamýz görüntüleme tekniklerinde patolojik bulgu olmadan da izole nervus vagus yaralanmasý olabileceðini göstermektedir.