Lower cranial nerve palsies due to internal carotid dissection

Area of Science:

• Neurology
• Vascular Surgery
• Radiology

Background:

• Collet-Sicard syndrome is a rare condition involving cranial nerves IX-XII palsy.
• Internal carotid artery dissection can lead to serious neurological complications.
• Aneurysm formation at the skull base can cause nerve compression.

Observation:

• A 41-year-old man presented with severe headache, neck pain, bruits, and complete unilateral cranial nerve palsy IX-XII after minor trauma.
• Imaging revealed bilateral internal carotid artery dissection with a skull base aneurysm compressing the jugular foramen.
• The patient suffered from severe dysphagia for one month.

Findings:

• Successful treatment involved occlusion of the internal carotid artery aneurysm using a detachable balloon.
• The patient showed rapid improvement in dysphagia following the intervention.
• This demonstrates a link between carotid dissection, aneurysm, and Collet-Sicard syndrome.

Implications:

• Endovascular occlusion is an effective treatment for carotid aneurysms causing nerve compression.
• Early diagnosis and intervention are crucial for managing this rare condition.
• This case expands understanding of the clinical presentation and management of carotid artery dissection complications.