Macroglossia associated with brainstem injury
Ifeanyi Iwuchukwu1, Agnieszka Ardelt, Wilson Cueva
1Division of Neurocritical Care, Department of Neurology, Ochsner Medical Center, New Orleans, LA, USA, iiwuchuk@tulane.edu.
Neurocritical Care
|September 5, 2013
Summary
Macroglossia and dysautonomia can complicate brainstem injuries, potentially leading to serious issues like cerebral edema. Early recognition and management are crucial for neurocritical care patients with posterior fossa injuries.
Area of Science:
- Neurology
- Neurosurgery
- Critical Care Medicine
Background:
- Macroglossia is a known complication of posterior fossa surgery, often attributed to venous engorgement or positioning.
- The exact etiology in the context of direct brainstem injury remains less understood.
Observation:
- Three patients developed macroglossia and central neurogenic dysautonomia following posterior fossa injury.
- These patients experienced significant hemodynamic fluctuations, requiring tracheostomy placement.
Findings:
- Macroglossia was treated effectively with dexamethasone.
- Dysautonomia resolved completely with beta-blockers and gabapentin.
Implications:
- Clinicians must recognize the association between brainstem injury and macroglossia with dysautonomia.
- This complication can exacerbate intracranial pressure and cerebral edema, posing risks in neurocritical care settings.
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