Macroglossia associated with brainstem injury

Ifeanyi Iwuchukwu, Agnieszka Ardelt, Wilson Cueva, Rwoof Reshi, Fernando Goldenberg, Jeffrey Frank

Research output: Contribution to journalArticlepeer-review


Background: Macroglossia has been reported in patients undergoing posterior fossa neurosurgical procedures and is thought to be as a result of venous engorgement from intubation or mechanical positioning during these prolonged procedures. Methods: We report three patients who developed macroglossia and dysautonomia of central neurogenic origin following brainstem injury. Results: The three patients developed macroglossia and dysautonomia with wide hemodynamic fluctuations in the setting of posterior fossa injury of the lower brainstem structures, necessitating tracheostomy placement. Macroglossia was managed with dexamethasone and there was complete resolution of dysautonomia while treated with beta-blockers and gabapentin. Conclusions: Neurointensivists should be aware of macroglossia with dysautonomia complicating brainstem injury, which may have perilous consequences in the setting of cerebral edema or intracranial hypertension.

Original languageEnglish (US)
Pages (from-to)106-110
Number of pages5
JournalNeurocritical Care
Issue number1
StatePublished - Feb 2014


  • Cerebral edema
  • Dysautonomia
  • Macroglossia
  • Somatoautonomic reflex
  • Vasomotor center

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