Collet-Sicard syndrome resulting from closed head injury: case report.

A 67-year-old man developed paralysis of the right ninth, tenth, eleventh, and twelfth cranial nerves (Collet-Sicard syndrome) after sustaining a closed head injury. Plain x-ray films of the skull revealed two linear fractures of the occipital bone (one of them probably traversing through the right occipital condyle) and a prominent soft-tissue shadow in the region of the nasopharynx, suggestive of a skull base fracture. The patient was managed conservatively. This is the only case of unilateral multiple caudal cranial nerve palsies (IX through XII), seen by us over a 20-year period, from among more than 5,000 moderate to significant head injuries.