Successful Delayed Endovascular Therapy for Multiple Lower Nerve Palsy Caused by Spontaneous Internal Carotid Artery Dissection

Spontaneous internal carotid artery dissection is a relatively common cause of stroke in younger patients. The occurrence of spontaneous internal carotid artery dissection with lower cranial nerve palsy is quite rare. However, few studies have reported its natural course or an effective treatment policy. We received a 42-year-old man with spontaneous internal carotid artery dissection presenting with multiple lower cranial nerve palsies. He exhibited difficulty in swallowing, dysarthria, and tongue deviation. After 2 months of conservative therapy, stent placement with coils was performed because the symptoms did not improve. The patient was discharged 4 days after the operation without any complications and showed evident improvement in symptoms. We reviewed cases of multiple lower cranial nerve palsies reported in the literature up to January 2025 and discussed the appropriate period of observation and the effectiveness of endovascular therapy for spontaneous internal carotid artery dissection with multiple lower cranial nerve palsies.