Vagus nerve paralysis due to skull base fracture.

Lower cranial nerve paralysis originating from skull base fracture is rare and isolated vagus nerve paralysis after close head injury is extremely rare. We, in this study, present the case of a 49-year-old man sustained a right vocal cord paralysis and dysphagia in a fighting accident. Initial examination, including flexible laryngoscope, esophagogram and fine-cut neck computed tomography scan, failed to find out the cause of isolated vagus paralysis. Until high resolution computed tomography of skull base revealed the jugular foramen bony disruption. One individual cranial nerve paralysis may be a significant sign for skull base fracture in closed head injury. Considering the serious consequences of the disease, thorough neurologic and radiologic examination are needed to evaluate the condition of skull base, and to develop reliable effective management for the neurologic sequalae, result from it.