This constellation of neurological deficits can be accounted for by trauma to the nerves that are close to the carotid bifurcation. The changes in skin sensation can be accounted for by a neurapraxia due to damage to cervical nerves. The alteration in sensation in the soft palate is due to neurapraxia of the glossopharyngeal nerve [IX]. The paralyzed left cord results from neurapraxia of the recurrent laryngeal nerve, while the inability to shrug the shoulder is due to neurapraxia of the accessory nerve [XI]. Deviation of the tongue can be accounted for by damage to the hypoglossal nerve [XII].