Vertebral Artery Dissecting Aneurysm Causing Central Tapia’s Syndrome: A Case Report

• DOI: 10.5469/neuroint.2021.00080
• Publication Date: 2021-06-24T08:08:51Z
• Authors: Yong Woo Shim; Jung Hyun Park; Sung-Tae Kim; Jin Wook Baek; Hyun Gon Lee; Jung Hae Ko; Sung Hwa Paeng; Se Young Pyo; Sung-Chul Jin; Hae Woong Jeong; Young Gyun Jeong
• Keywords: tapia’s syndrome; Medicine (General); endovascular procedures; Neurosciences. Biological psychiatry. Neuropsychiatry; Case Report; 3. Good health; 03 medical and health sciences; R5-920; 0302 clinical medicine; vertebral artery dissection; medulla oblongata; high-resolution magnetic resonance imaging; RC321-571

The central type of Tapia’s syndrome is an extremely rare presentation, characterized by unilateral paralysis of the vagal and hypoglossal nerves, contralateral hemiparesis, or hemihypesthesia. This report describes a case of a middle-aged patient who developed central Tapia’s syndrome due to a right vertebral artery dissecting aneurysm (VADA). The patient complained about swallowing difficulty and odynophagia. Right vocal cord paralysis, mild tongue deviation to the right side, left hypesthesia, and decreased temperature sensation with left hemiparesis were observed in neurologic exams. A right VADA and compression of the medulla oblongata due to the VADA were diagnosed on magnetic resonance imaging. Endovascular flow diversion of the right VADA was performed. After 1 year, all neurological symptoms and vocal cord paralysis were nearly resolved, but left hypesthesia remained with decreased nociception. We present and discuss how a VADA caused those symptoms and propose endovascular flow diversion as a treatment option.