Collet-Sicard syndrome: a rare but important presentation of internal jugular vein thrombosis.
We describe a rare neurological presentation of internal jugular vein thrombosis induced by central venous catheter placement in a patient with cancer. A 71-year-old man gave a 3-week history of dysphagia and dysarthria with left-sided neck pain and headache. He was receiving chemotherapy for appendiceal adenocarcinoma. On examination, he had left 9th-12th cranial neuropathies, manifesting as voice hoarseness, decreased palatal movement, absent gag reflex, weakness of scapular elevation and left-sided tongue wasting. CT scan of neck showed the left subclavian central venous catheter tip was in the left internal jugular vein. Skull base MRI showed thrombus within the left jugular foramen extending intracranially. We diagnosed Collet-Sicard syndrome secondary to thrombosis in the sigmoid-jugular venous complex. His headache and neck pain resolved 2 days after removing the catheter and starting anticoagulation. Collet-Sicard syndrome is an unusual syndrome of lower cranial nerve palsies, often signifying disease at the skull base, including malignancy, trauma or vascular causes.
Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore.
Shermyn
http://orcid.org/0000-0002-3362-2717
S
Neo
Mount Elizabeth Medical Centre, Singapore.
Kim En
KE
Lee
D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003389:Cranial Nerve Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging*; D008297:Male; D013577:Syndrome; D020246:Venous Thrombosis / Q000150:complications / Q000000981:diagnostic imaging*
CLINICAL NEUROLOGY; DYSPHAGIA; HEADACHE; NEUROANATOMY; NEURORADIOLOGY