• Yassine El Hassani, Ana Paula Narata, Vitor Mendes Pereira, and Carlo Schaller.
• Department of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland. yassine.elhassani@hcuge.ch
• J Neurol Surg A Cent Eur Neurosurg. 2012 May 1;73(3):171-4.

ObjectiveThe purpose of this study is to report a case of presumably neurogenic macroglossia that occurred after surgical trapping of a vertebral artery (VA)-posteroinferior cerebellar artery aneurysm, and to analyze its potential pathogenesis.Clinical PresentationA 53-year-old woman who suffered from headaches and intermittent loss of consciousness but without evidence of subarachnoid hemorrhage was admitted. Magnetic resonance imaging and angiography showed an irregular aneurysm in the fourth segment of a left dominant VA.InterventionSurgical treatment was indicated after discussion with the neuroradiology team. During surgery, in the prone position the aneurysm ruptured. The patient became hemodynamically instable. On the first postoperative day, macroglossia appeared and remained for 3 weeks until spontaneous regression.ConclusionMacroglossia is a rare complication following neurosurgical procedures with very few cases reported so far. It has been attributed to the sitting position and venous flow congestion. We illustrate a case of macroglossia, which occurred following surgery in the prone position. Its etiology remains speculative, but a neurogenic explanation seems most plausible.Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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