[Collet-Sicard syndrome after carotid artery dissection]

Area of Science:

• Neurology
• Neuroscience
• Vascular Neurology

Background:

• Collet-Sicard syndrome is a rare neurological disorder characterized by unilateral palsy of the lower four cranial nerves (IX, X, XI, XII).
• It is distinguished from Villaret syndrome by the absence of sympathetic nervous system involvement.
• Etiologies typically include skull base tumors, head and neck trauma, and carotid artery dissection.

Observation:

• A 57-year-old male patient presented with symptoms indicative of left-sided Collet-Sicard syndrome.
• The patient reported a history of a seemingly minor neck injury preceding the onset of symptoms.
• Clinical examination revealed palsy of the left lower cranial nerves IX-XII.

Findings:

• The patient's neurological deficits were directly attributed to a dissection of the left carotid artery.
• The carotid artery dissection was identified as the causative factor for the lower cranial nerve palsies.
• The absence of sympathetic involvement confirmed the diagnosis as Collet-Sicard syndrome, differentiating it from Villaret syndrome.

Implications:

• This case underscores the potential for seemingly trivial neck trauma to precipitate serious vascular events like carotid artery dissection.
• It emphasizes the importance of considering vascular causes, particularly carotid dissection, in the differential diagnosis of Collet-Sicard syndrome.
• Early recognition and management of carotid artery dissection are crucial for preventing further neurological damage and improving patient outcomes.