Recurrent macroglossia requiring tracheostomy after haemorrhagic basal ganglia stroke

Muyinat Y. Osoba, Alexander L. Schneider, Borislav Alexiev, Akihiro J. Matsuoka

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

A 50-year-old African American woman with hypertension, congestive heart failure, chronic kidney disease and prior cerebral vascular accident was transferred from an outside hospital after being found unresponsive and subsequently intubated for severe orolingual swelling. Imaging showed left thalamic haemorrhagic stroke, and the lingual swelling was clinically concerning for angio-oedema, with which a lingual biopsy was consistent. Work-up was negative for hereditary or acquired angio-oedema, and imaging was negative for structural causes. Of note, the patient had an episode of severe orolingual swelling 3 months prior to this presentation after suffering left thalamic haemorrhage which self-resolved after approximately 2 months. In both episodes lingual swelling predated receipt of tissue plasminogen activator and she had discontinued ACE inhibitor therapy since her first episode of tongue swelling. Despite medical and supportive management, tongue swelling progressed during admission and the decision was made to allow the patient's tongue swelling to self-resolve.

Original languageEnglish (US)
JournalBMJ case reports
Volume14
Issue number1
DOIs
StatePublished - Jan 11 2021

Keywords

  • dentistry and oral medicine
  • head and neck surgery
  • oral and maxillofacial surgery
  • otolaryngology / ENT
  • stroke

ASJC Scopus subject areas

  • General Medicine

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