A case of Collet-Sicard syndrome associated with traumatic atlas fractures and congenital basilar invagination.
An 18 year old man with congenital basilar invagination developed multiple lower cranial nerve (CN) palsies including CN IX to XII after a traffic accident. Computed tomography of his skull base revealed a two part atlas Jefferson fracture. Normally, lower cranial nerves (CN IX-XII) pass through a space between the styloid process and the atlas transverse process. Atlas burst fractures rarely cause neurological deficits because of a greater transverse and sagittal diameter of the spinal canal at the atlas, and a tendency of the lateral masses to slide away from the cord after injury. However, when associated with a rare condition-congenital basilar invagination-atlas fractures can compromise the space and make CN IX-XII more vulnerable to compression injury. This report discusses the correlation between the anatomical lesions and clinical features of this patient.
Hsu
H P
HP
Department of Neurology, Chang Gung Memorial Hospital and Chang Gung University, 199 Tun Hwa North Road, Taipei, Taiwan 10591.
Chen
S T
ST
Chen
C J
CJ
Ro
L S
LS
D000063:Accidents, Traffic; D000293:Adolescent; D001270:Cervical Atlas / Q000000981:diagnostic imaging / Q000293:injuries*; D006259:Craniocerebral Trauma / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D050723:Fractures, Bone / Q000150:complications; D020435:Glossopharyngeal Nerve Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D020437:Hypoglossal Nerve Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D009777:Occipital Bone / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D014826:Vocal Cord Paralysis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology