Q: 52 year old female is in ICU after Carotid Endarterectomy (CEA). Nurse called you to bedside and reports that patient tongue is deviated. Your diagnosis?


 Answer: Hypoglossal nerve injury

The hypoglossal nerve supplies motor function to the tongue. Injury to  hypoglossal is one of the more common cranial nerve injury associated with CEA. It is manifested as tongue deviation towards the side of surgery (CEA). Risk factors include inadvertent retraction or transection.