Smith Rupert, Tassone Peter, Saada Janak
Norwich Medical School, University of East Anglia, Norwich, UK.
BMJ Case Rep. 2013 Jul 31;2013:bcr2013200358. doi: 10.1136/bcr-2013-200358.
A 52-year-old man presented with sudden onset symptoms of multiple cranial nerve palsies (IX, X and XII) following a 10-day history of coryzal illness. Follow-up examination established atrophy of the trapezius suggesting additional involvement of the spinal accessory nerve (XI). Further investigation including CT and MRI demonstrated dissection of the internal carotid artery. Given the involvement of cranial nerves IX to XII, and that the patient demonstrated no signs of Horner's syndrome, we suggested that this patient fits the description of Collet-Sicard syndrome. On vascular opinion the carotid dissection was expected to resolve without intervention but the patient was prescribed aspirin for thromboprophylaxis. Gradual resolution of neurological symptoms was observed at 8-week follow-up.
一名52岁男性,在出现10天的感冒样疾病史后,突然出现多发性颅神经麻痹(IX、X和XII)症状。后续检查发现斜方肌萎缩,提示副神经(XI)也受累。包括CT和MRI在内的进一步检查显示颈内动脉夹层。鉴于IX至XII颅神经受累,且患者未表现出霍纳综合征的体征,我们认为该患者符合科莱-西卡尔综合征的描述。血管科医生认为,颈动脉夹层预计无需干预即可自行缓解,但仍为患者开了阿司匹林进行血栓预防。在8周的随访中,观察到神经症状逐渐缓解。