In patients diagnosed with cervical artery dissection, which cranial nerve is likely implicated by symptoms of weakness and pain?

• A. CN 5
• B. CN 7
• C. CN 12
• D. CN 11

Answer: (C)

In cases of cervical artery dissection, particularly involving the vertebral artery, it's common for patients to experience symptoms related to cranial nerves due to their anatomical proximity to the affected vascular structures. The twelfth cranial nerve, known as the hypoglossal nerve, controls the muscles of the tongue. Damage or irritation to this nerve can result in weakness of the tongue muscles, leading to symptoms such as difficulty speaking or swallowing and deviation of the tongue to the affected side when protruded.

Cervical artery dissection can lead to vascular complications including embolic strokes, which may compromise blood supply to areas of the brain involved with cranial nerve function. In this instance, symptoms could manifest as weakness and pain associated with the hypoglossal nerve due to its critical role in tongue movement and the close relationship to the vertebral artery. This understanding highlights the clinical relevance of recognizing cranial nerve involvement in patients with cervical artery dissection, providing insights into their neurological assessment and management.