Isolated Hypoglossal Nerve Palsy Secondary to Basilar Artery Dolichoectasia

Hypoglossal nerve palsy is commonly associated with metastatic tumors, trauma, and vascular anomalies, with vertebrobasilar artery dolichoectasia being an exceptionally rare etiology.This case report describes a 57-year-old male presenting with isolated hypoglossal nerve palsy attributed to basilar artery dolichoectasia, confirmed through digital subtraction angiography, which revealed significant vascular dilation and tortuosity.The patient was treated with a regimen of antihypertensive and antiplatelet agents, resulting in substantial clinical improvement over a six-month follow-up period.This report highlights the clinical significance of vertebrobasilar artery dolichoectasia as a rare but critical factor in isolated cranial nerve palsy, addressing the diagnostic complexities and therapeutic considerations involved.The case underscores the importance of advanced neuroimaging in identifying subtle vascular anomalies and demonstrates the benefit of a multidisciplinary approach in managing such rare presentations.