Middle cerebral artery infarction following common carotid compression due to a multiloculated parapharyngeal abscess
Deep neck space infections (DNSIs) include retropharyngeal and parapharyngeal abscesses. We report a rare complication of left-sided middle cerebral artery infarction precipitated by left common carotid artery compression secondary to a multiloculated parapharyngeal abscess. A 59-year-old woman with...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2020-03-01
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| Series: | Proceedings of Singapore Healthcare |
| Online Access: | https://doi.org/10.1177/2010105819887984 |
| _version_ | 1811294942616616960 |
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| author | Raja Ezman Faridz bin Raja Shariff Sapiah Sapuan |
| author_facet | Raja Ezman Faridz bin Raja Shariff Sapiah Sapuan |
| author_sort | Raja Ezman Faridz bin Raja Shariff |
| collection | DOAJ |
| description | Deep neck space infections (DNSIs) include retropharyngeal and parapharyngeal abscesses. We report a rare complication of left-sided middle cerebral artery infarction precipitated by left common carotid artery compression secondary to a multiloculated parapharyngeal abscess. A 59-year-old woman with poorly controlled diabetes was admitted following a loss of consciousness. Examination demonstrated unilateral right-sided hemiparesis and computed tomography (CT) of the brain revealed an acute left-sided frontoparietal infarct. The patient had been complaining of a fever, left-sided ear redness and pain six days prior. Unfortunately, despite antibiotics in the community, her ear pain worsened to involve her left jaw. Closer examination revealed a swelling in her left submandibular region and a CT of her neck was performed, revealing a multiloculated left parapharyngeal abscess with evidence of left common carotid compression. A naso-pharyngo-laryngoscopy (NPLS) was performed to confirm the presence of an abscess. Owing to the size and complex location of the abscess, management via a prolonged antibiotic treatment was opted for over surgical intervention. After completion there was improvement in medical state and resolution on repeat NPLS. Vascular-related complications are rare following DNSI. Carotid artery compression has been reported, although current literature suggests it to be a benign phenomenon. Our case is the first reported instance of a parapharyngeal abscess with severe neurological complications, reminding physicians that such complications following a DNSI remain possible. Although rare, in the event of a cerebrovascular accident and sepsis, DNSI remains a possible cause to be considered. |
| first_indexed | 2024-04-13T05:24:58Z |
| format | Article |
| id | doaj.art-b839eed6baf74670ae68acba98c5fa40 |
| institution | Directory Open Access Journal |
| issn | 2010-1058 2059-2329 |
| language | English |
| last_indexed | 2024-04-13T05:24:58Z |
| publishDate | 2020-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Proceedings of Singapore Healthcare |
| spelling | doaj.art-b839eed6baf74670ae68acba98c5fa402022-12-22T03:00:37ZengSAGE PublishingProceedings of Singapore Healthcare2010-10582059-23292020-03-012910.1177/2010105819887984Middle cerebral artery infarction following common carotid compression due to a multiloculated parapharyngeal abscessRaja Ezman Faridz bin Raja Shariff0Sapiah Sapuan1Universiti Teknologi MARA (UITM), Selangor, MalaysiaSungai Buloh Hospital, Selangor, MalaysiaDeep neck space infections (DNSIs) include retropharyngeal and parapharyngeal abscesses. We report a rare complication of left-sided middle cerebral artery infarction precipitated by left common carotid artery compression secondary to a multiloculated parapharyngeal abscess. A 59-year-old woman with poorly controlled diabetes was admitted following a loss of consciousness. Examination demonstrated unilateral right-sided hemiparesis and computed tomography (CT) of the brain revealed an acute left-sided frontoparietal infarct. The patient had been complaining of a fever, left-sided ear redness and pain six days prior. Unfortunately, despite antibiotics in the community, her ear pain worsened to involve her left jaw. Closer examination revealed a swelling in her left submandibular region and a CT of her neck was performed, revealing a multiloculated left parapharyngeal abscess with evidence of left common carotid compression. A naso-pharyngo-laryngoscopy (NPLS) was performed to confirm the presence of an abscess. Owing to the size and complex location of the abscess, management via a prolonged antibiotic treatment was opted for over surgical intervention. After completion there was improvement in medical state and resolution on repeat NPLS. Vascular-related complications are rare following DNSI. Carotid artery compression has been reported, although current literature suggests it to be a benign phenomenon. Our case is the first reported instance of a parapharyngeal abscess with severe neurological complications, reminding physicians that such complications following a DNSI remain possible. Although rare, in the event of a cerebrovascular accident and sepsis, DNSI remains a possible cause to be considered.https://doi.org/10.1177/2010105819887984 |
| spellingShingle | Raja Ezman Faridz bin Raja Shariff Sapiah Sapuan Middle cerebral artery infarction following common carotid compression due to a multiloculated parapharyngeal abscess Proceedings of Singapore Healthcare |
| title | Middle cerebral artery infarction following common carotid compression due to a multiloculated parapharyngeal abscess |
| title_full | Middle cerebral artery infarction following common carotid compression due to a multiloculated parapharyngeal abscess |
| title_fullStr | Middle cerebral artery infarction following common carotid compression due to a multiloculated parapharyngeal abscess |
| title_full_unstemmed | Middle cerebral artery infarction following common carotid compression due to a multiloculated parapharyngeal abscess |
| title_short | Middle cerebral artery infarction following common carotid compression due to a multiloculated parapharyngeal abscess |
| title_sort | middle cerebral artery infarction following common carotid compression due to a multiloculated parapharyngeal abscess |
| url | https://doi.org/10.1177/2010105819887984 |
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