Mnari Walid, Kilani Mohamed, Harrathi Khaled, Maatouk Mezri, Koubaa Jamel, Golli Mondher
Imaging Department, Fattouma Bourguiba University Hospital, Medical university, Monastir, Tunisia.
Neurosurgery Department, Fattouma Bourguiba University Hospital, Medical university, Monastir, Tunisia.
Pan Afr Med J. 2016 Mar 30;23:143. doi: 10.11604/pamj.2016.23.143.9143. eCollection 2016.
Posttraumatic Unilateral paralysis of the last four cranial nerves (IX-XI), known as collet-Sicard syndrome, is rare following closed head injury. A 21-year-old man presented with slurred speech, hoarseness voice and difficulty swallowing his saliva following closed head trauma. The cranial nerve examination revealed left sided severe dysfunction of cranial nerves VII, IX, X, XI, and XII. A CT-Scan of the neck was performed demonstrating a fracture of the left styloid process at the base of the skull. The Magnetic Resonance Imaging showed unusually well seen lower cranial nerves due to nerve edema. The patient was managed conservatively with steroids and regular sessions of neuromuscular and orthophonic rehabilitation. The nutrition had to be administered by gastrostomy since he was unable to swallow. Six months after the injury a total neurological recovery was noted. We present the exceptional case of Collet-Sicard Syndrome caused by styloid process fracture.
创伤后最后四对颅神经(IX - XI)单侧麻痹,即科莱 - 西卡尔综合征,在闭合性颅脑损伤后较为罕见。一名21岁男性在闭合性颅脑外伤后出现言语含糊、声音嘶哑及吞咽唾液困难。颅神经检查显示左侧颅神经VII、IX、X、XI和XII严重功能障碍。颈部CT扫描显示颅底左侧茎突骨折。磁共振成像显示由于神经水肿,低位颅神经显示异常清晰。患者接受了类固醇保守治疗以及定期的神经肌肉和正音康复治疗。由于他无法吞咽,必须通过胃造口术给予营养支持。受伤六个月后,神经功能完全恢复。我们报告了一例由茎突骨折引起的科莱 - 西卡尔综合征的特殊病例。