Collet-Sicard Syndrome Research Articles

Occipital condyle fracture with unilateral collet-Sicard Syndrome

Background: Occipital condylar fractures (OCF) are uncommon injuries usually resulting from high-energy blunt trauma. They have been under-diagnosed. Posttraumatic unilateral paralysis of the last four cranial nerves, known as collet-Sicard syndrome, is rare following OCF. Aim: To report a case of OCF with unilateral Collet-Sicard syndrome. Case report: A 42-year-old man was admitted after being involved in a car accident with left collet-Sicard syndrome due to OCF. A brief review of the literature on OCF associated with lower cranial nerve palsy is reported. Conclusion: Emergency doctors and neurosurgeons must be aware of the OCF with lower cranial palsy, to not be misdiagnosed.

Collet–Sicard Syndrome Caused by Spontaneous Internal Carotid Artery Dissection: A Case Report and Review of Literature

Collet–Sicard Syndrome Caused by Spontaneous Internal Carotid Artery Dissection: A Case Report and Review of Literature

Collet-Sicard syndrome due to cervical artery dissection disclosed by high-resolution magnetic resonance imaging.

Cervical artery dissection (CAD) represents a leading cause of unilateral lower cranial nerve IX-XII palsy, known as Collet-Sicard syndrome (CSS). High-resolution magnetic resonance imaging (HR-MRI) is widely used in the evaluation of patients with CAD, providing information regarding vessel wall abnormalities and intraluminal thrombus. We present a patient with palsy of multiple lower cranial nerves in the context of CSS, attributed to unilateral spontaneous internal carotid artery dissection. We describe a 68-year-old man with unremarkable previous history, who presented with subacute, gradually worsening dysphagia and hoarse voice. Clinical examination revealed right-sided palsy of cranial nerves IX-XII. Three-dimensional fat-saturated black-blood T1-weighted high-resolution vessel wall imaging disclosed spontaneous dissection with intramural hematoma along the distal right internal carotid artery. Neck MRI showed inward displacement of right aryepiglottic fold, right pyriform sinus dilatation, and right true vocal cord in middle position, indicative of right vagus nerve palsy, atrophy of right trapezius and sternocleidomastoid muscles, due to right spinal accessory nerve palsy, and unilateral tongue atrophy with fatty infiltration, characteristic for right hypoglossal nerve palsy. This case highlights the utility of high-resolution vessel wall imaging and especially fat-saturated T1-weighted black-blood SPACE (sampling perfection with application-optimized contrast using different flip-angle evolutions) sequences in the accurate diagnosis of CAD, revealing the characteristic mural hematoma and intimal flap. HR-MRI is also valuable in the recognition of indirect signs of lower cranial nerve compression.

Combined Deficit of the Four Lower Cranial Nerves also Known as the Syndrome of Collet-Sicard: A Systematic Review and Meta-analysis.

Combined deficit of the four lower cranial nerves (CN IX, X, XI, and XII) was originally described by French physicians Collet (1915) and Sicard (1917) during World War I. To date though, this rare neurological clinical picture lacks systematic evidence regarding its epidemiology, clinical presentation, treatment strategies, and outcome. We conducted a systematic review and meta-analysis concerning Collet-Sicard syndrome (CSS) on Medline database in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The research yielded 84 articles among which 73 individual case reports were eventually retained. Mean age was 53.7 (± 16) years old and the male-to-female ratio was 1.8/1. CSS was firstly caused by tumors (38.4%), following by vascular etiologies (28.8%), trauma (16.4%), and infection (6.8%), among others. Temporary enteral nutrition was required for 17 patients (23.3%). The four CN presented significant chances of complete or partial recovery: 52.1% for CN IX ( p < 0.001), 46.6% for CN X and CN XII ( p < 0.001), and 39.7% for CN XI ( p = 0.002). Tumoral causes presented significantly lower chances of favorable CN recovery (7.1%) compared to infection (60%), vascular (52.4%), and trauma (41.7%) ( p < 0.001). Older age (> 53 years old) was not associated with a dismal CN prognostic ( p = 0.763). Most patients (71.2%) presented a favorable outcome (Glasgow Outcome Scale score ≥ 4). All the patients who died (6.8%) suffered from skull base tumors. CSS is a rare condition requiring prompt clinical and radiologic diagnostic and multidisciplinary management. Vascular or infectious-related CSS seem to present a rather good prognostic, closely followed by trauma, whereas tumoral-related CSS seem to suffer from a more dismal prognostic.

Collet-Sicard syndrome: prelude to a systematic review and meta-analysis.

Collet-Sicard syndrome: prelude to a systematic review and meta-analysis.

Course of Rehabilitation Treatment of Neuralgic Amyotrophy Presenting with Collet-Sicard Syndrome

Course of Rehabilitation Treatment of Neuralgic Amyotrophy Presenting with Collet-Sicard Syndrome

Collet-Sicard syndrome: a scoping review.

Collet-Sicard syndrome (CSS) is the unilateral palsy of the cranial nerves (CN) IX, X, XI, and XII. To our knowledge, no review describes the characteristics of patients diagnosed with CSS. Therefore, this review aims to collect and describe all cases in the literature labeled as CSS. We performed a scoping review of the literature and conducted a database search in Embase and PubMed. We included articles and abstracts with case reports or case series of patients with CSS diagnosis. We classified the cases into two groups: "CSS", referring to patients presenting exclusively with IX-XII nerve involvement, and "CSS-plus", which corresponds to cases with CSS and other neurological impairments. We included 135 patients from 126 articles, of which 84 (67.7%) were male. The most common clinical manifestations reported were dysphagia and dysphonia. The most common etiology was tumoral in 53 cases (39.6%) and vascular in 37 cases (27.6%). The majority of patients showed partial or total improvement, with just over half receiving conservative treatment. The most frequent anatomic space was the jugular foramen (44.4%) and the parapharyngeal retrostyloid space (28.9%). Approximately 21% of the patients had other CN impairments, with the seventh and eighth CN most frequently compromised. We conclude that although there is a need for greater rigor in CSS reporting, the syndrome has a clear utility in identifying the localization of jugular foramen and parapharyngeal retrostyloid space pathology.

Be careful of Collet-Sicard syndrome: A rare result of carotid artery dissection.

Be careful of Collet-Sicard syndrome: A rare result of carotid artery dissection.

Delayed Collet-Sicard syndrome after internal carotid dissection and Jefferson fracture. Case report and Review of Literature

Background: Lower cranial nerve palsies, or Collet-Sicard syndrome, can be caused by many different etiologies including head trauma, basilar occipital fractures, tumors, and interventions. Few reports describe different presentations of this condition, and we present here a case study to increase awareness of and add to the variable spectrum.Case Description: A 56-year-old who had been hit while diving was admitted to our department. On examination, he was conscious without any signs of lateralization but presented with severe neck pain. CT brain and cervical spine revealed a C1 fracture with bilateral symmetrical fracture of the anterior and posterior arches (Jefferson’s fracture) and slight bilateral joint dislocation C1-C2 discreetly predominant on the left. One week later, he presented with dysarthria, dysphonia, swallowing disorder, anisocoria, tongue deviation, and palate deviation (XII, IX, and X). CT Angiography showed dissection of the internal carotid artery immediately after the carotid bulb. He has been treated conservatively with curative anticoagulants with stable symptoms. No surgical intervention had been proposed.Conclusion: Adding to the literature, delayed Collet-Sicard syndrome and lower cranial affection can be caused by missed carotid wall hematoma following severe craniocervical trauma associated with Jefferson’s fracture.

Collet-Sicard Syndrome as the Presentation of Malignant Pheochromocytoma.

Collet-Sicard Syndrome as the Presentation of Malignant Pheochromocytoma.

Collet-Sicard Syndrome Secondary to Internal Carotid Artery Dissection: A Firing Link.

Collet-Sicard Syndrome Secondary to Internal Carotid Artery Dissection: A Firing Link.

Jugular Paraganglioma Presenting With Collet-Sicard Syndrome

A 60-year-old woman presented with a 4-year history of right-sided pulsatile tinnitus and progressive hearing loss. She reported 2 years of worsening nasal reflux, dysphonia, dysphagia, right shoulder weakness, dysarthria, and difficulty moving her tongue. Physical examination was significant for a red pulsatile middle ear mass. Examination also revealed palatal asymmetry, right vocal cord paralysis, right shoulder depression with trapezius atrophy, and tongue deviation to the right, findings consistent with right-sided paralysis of cranial nerves IX through XII, respectively (Figure and Supplemental Video, available online at http://www.mayoclinicproceedings.org). Imaging revealed a large erosive lesion centered on the jugular foramen with extension into the middle ear. A jugular paraganglioma with lower cranial nerve involvement was diagnosed. In this case, the tumor resulted in Collet-Sicard syndrome, a rare jugular foramen syndrome describing paralysis of cranial nerves IX, X, XI, and XII. eyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiI5YjdkNjcyODViOThlOTBmYjU5YzcxNTUwNDgxY2Y2ZCIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNjc5MDIzMzQ3fQ.pC24mhoGY7fKBt_inedCGMLbKI49YeXR0YRBJUFFEgFPdG-3dpokPq8SAuGnPuNlQmjHssHa1JEWhPc2B-WmcogEq1UY5L2y8Hr0ea6U2dwtX-iOUTuZ-sHtSRSohkNi9tMBNr9cBid__VP0uefGvzYh-3sCjMJQG9EcYDj5kl23zqE0_-MbDBmDMrI1AdSOqCi_Eu7GM6ltL07QQKEUFzzJf6CNH4u6Tzoa5dG0hfEmvQz0gcjvDkCo-b49NFUYb04-fTptqGASLqQV-Zs9Gw4iAqXqtuTpIDjXCyA-fhRpydzP2jQ8B6sVy8DuEA9VvGIWcskZtEy7PnwHYu5hGg Download .mp4 (50.93 MB) Help with .mp4 files Supplemental Video Supplemental material can be found online at: http://www.mayoclinicproceedings.org. Supplemental material attached to journal articles has not been edited, and the authors take responsibility for the accuracy of all data.

The collet-sicard syndrome and dentistry: case report

ABSTRACT The Vernet, Collet-Sicard and Villaret Syndromes are uncommon; they affect the spaces through which some of the cranial nerves pass and can lead to the impairment of motor functions of the tongue. The etiology is variable, including benign or malignant tumors, metastasis, infections, or Idiopathic causes. Patients with the disease may report changes in the mobility and function of the tongue, dysphonia, dysarthria and dysphagia. The purpose of this article was present a case report of Collet-Sicard syndrome, and to highlight the importance of proper diagnosis by dentists. Appropriate treatment must be instituted as soon as possible and the patient should be treated by a multidisciplinary team until the complete remission of symptoms.

Severe localised granulomatosis with polyangiitis (Wegener\u2019s granulomatosis) manifesting with extensive cranial nerve palsies and cranial diabetes insipidus: a case report and literature review

BackgroundGranulomatosis with polyangiitis (GPA, formerly Wegener’s granulomatosis) is a multisystem vasculitis of small- to medium-sized blood vessels. Cranial involvement can result in cranial nerve palsies and, rarely, pituitary infiltration.Case presentationWe describe the case of a 32 year-old woman with limited but severe GPA manifesting as progressive cranial nerve palsies and pituitary dysfunction. Our patient initially presented with localised ENT involvement, but despite treatment with methotrexate, she deteriorated. Granulomatous inflammatory tissue around the skull base resulted in cavernous sinus syndrome, facial nerve palsy, palsies of cranial nerves IX-XII (Collet-Sicard syndrome), and the rare complication of cranial diabetes insipidus due to pituitary infiltration. The glossopharyngeal, vagus and accessory nerve palsies resulted in severe dysphagia and she required nasogastric tube feeding. Her neurological deficits substantially improved with treatment including high dose corticosteroid, cyclophosphamide and rituximab.ConclusionsThis case emphasises that serious morbidity can arise from localised cranial Wegener’s granulomatosis in the absence of systemic disease. In such cases intensive induction immunosuppression is required. Analysis of previously reported cases of pituitary involvement in GPA reveals that this rare complication predominantly affects female patients.

Collet-Sicard Syndrome With Hypoglossal Nerve Schwannoma: A Case Report.

Collet-Sicard syndrome is a rare syndrome that involves paralysis of 9th to 12th cranial nerves. We report an uncommon case of schwannoma of the hypoglossal nerve in a 39-year-old woman presented with slurred speech, hoarse voice, and swallowing difficulty. Physical examination revealed decreased gag reflex on the right side, decreased laryngeal elevation, tongue deviation to the right side, and weakness of right trapezius muscle. MRI revealed a mass lesion in the right parapharyngeal space below the jugular foramen. The tumor was surgically removed. It was confirmed as hypoglossal nerve schwannoma via pathologic examination. Videofluoroscopic swallowing study revealed aspiration of liquid food and severe bolus retention in the vallecula and piriform sinus. Laryngoscopy revealed right vocal cord palsy. Electrodiagnostic study revealed paralysis of the right 11th cranial nerve. In summary, we report an uncommon case of schwannoma of the hypoglossal nerve with 9th to 12th cranial nerve palsy presenting as Collet-Sicard syndrome.

Collet-Sicard syndrome as a complication of chronic middle ear infection

Collet-Sicard syndrome as a complication of chronic middle ear infection

Head injury in infant with Collet-Sicard syndrome: A case report

Head injury in pediatric age groups causes lesser mass and structural lesions in comparison to adults, because the pediatric brain is more compressible and calvarium more pliable. Occipital condyle fracture with multiple cranial nerve involvement in pediatric age is a rare phenomenon. We report a case of head injury in 1-year-old female child who presented with sixth, seventh and lower cranial nerve paresis with an occipital condylar fracture. Tere have been no previous reports of such a presentation in this age group. The mechanism, management and outcome of such cases are discussed in this respect.

Unusual Presentation of Prostate Adenocarcinoma: Collet-Sicard Syndrome with Dysfunctions of Cranial Nerves VII and VIII

Collet-Sicard syndrome is characterized by the unilateral paralysis of cranial nerves IX-XII. The most common cause is an extra- dural tumor in the posterior fossa. This syndrome may occasionally occur because of distant metastases. Collet-Sicard syndrome which results from metastatic prostate carcinoma is very rare. A review of the English literature showed that this is the second report of metastatic prostate carcinoma with Collet-Sicard syndrome and dysfunctions of cranial nerves VII and VIII. On the other hand, this is the first report of a patient with prostate carcinoma who initially presented with Collet-Sicard syndrome and showed dysfunctions of cranial nerves VII and VIII.

Traumatic brain injury: Lower cranial nerves palsy

Three patients, 16 to 20 years, suffered a head injury, presented a multiple cranial nerve impairment, confirmed 18.7 ± 4.5 days after admission. All underwent ventilation and enteral nutrition for severe swallowing disorders. Etiology is peripheral (2 traumatic Collet-Sicard syndrome : constellation of cranial nerves palsies due to a lesion at jugular foramen (IX, X, XI) with adjonction to XII) or central (brain stem contusion). Swallowing and voice survey at 1 year is favorable. Conclusion

Collet–Sicard syndrome: a rare cause of hypoglossal nerve palsy

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