Collet Sicard syndrome: A rare manifestation of jugular nerve schwannoma

Collet-Sicard syndrome (CSS), also known as condylar jugular syndrome, is a neurological entity characterized by concurrent lower cranial nerve palsies (cranial nerves IX-XII) due to lesions involving both, the jugular foramen as well as the hypoglossal canal. CSS can be due to a variety of causes, including neoplastic as well as non-neoplastic processes, among which jugular foramen schwannomas are a rare but significant cause. We present the case of a 56-year-old male who presented with hoarseness of voice, slowly progressive dysphagia, and difficulty in walking. Examination revealed characteristic findings pointing towards cumulative involvement of lower cranial nerves, upon which a contrast-enhanced MRI of the brain was advised. CE-MRI brain revealed a large mass lesion with signals characteristic of a schwannoma involving the left jugular foramen and extending inferiorly to involve the hypoglossal canal, explaining the involvement of all 4 lower cranial nerves. A preoperative NCCT of the brain confirmed the expansion of these canals. Based on the clinical details and characteristic MRI findings, a diagnosis of CSS secondary to a Jugular Schwannoma was made, which was later confirmed on histopathology. This case highlights the importance of clinico-radiological integration in the early diagnosis of CSS, ascertaining its etiology, and providing a roadmap for timely intervention.