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

Author:

Al-Shabibi Talal1,Hamdi Hussein2,Balaha Ahmed2,Ghoraba Yasser2,Kaya Jean-Marc1

Affiliation:

1. Department of Neurosurgery, Hôpitaux Universitaires de Marseille Nord, Aix Marseille University, Marseille, France,

2. Department of Neurosurgery, Tanta University, Tanta, Gharbeya, Egypt.

Abstract

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.

Publisher

Scientific Scholar

Subject

Clinical Neurology,Surgery

Reference22 articles.

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4. Collet-Sicard syndrome associated with occipital condyle fracture and epidural hematoma;Erol;Yonsei Med J,2007

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