Isolated vagal nerve palsy associated with a dissection of the extracranial internal carotid artery

A 40-year-old man had paralysis of the right vocal cord. Imaging showed a d issection of the extracranial internal carotid artery, and physical examina tion disclosed paresis of the right side of the soft palate, To our knowled ge, this is only the second report of carotid dissection presenting as an i solated vagal neuropathy, Most often, multiple lower cranial nerves are inv olved. The CT, MR imaging, and MR angiographic findings are presented and t he topic is reviewed.