Collier's sign: Difference between revisions
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{{Infobox medical condition | |||
| name = Collier's sign | |||
| synonyms = Collier's tucked lid sign | |||
| field = [[Neurology]] | |||
| symptoms = [[Eyelid retraction]] | |||
| causes = [[Dorsal midbrain syndrome]], [[Parinaud's syndrome]], [[Pineal gland tumor]] | |||
| diagnosis = [[Clinical diagnosis]] | |||
| differential = [[Thyroid eye disease]], [[Horner's syndrome]] | |||
| treatment = Treatment of underlying cause | |||
| prognosis = Depends on underlying condition | |||
| frequency = Rare | |||
}} | |||
'''Collier's sign''', also known as the '''posterior fossa stare''' or '''tucked lid sign''', is a clinical sign that indicates a dysfunction in the midbrain, particularly involving the structures responsible for vertical gaze. This sign is characterized by bilateral eyelid retraction, giving the appearance of a fixed and wide-eyed stare. It is often associated with lesions in the dorsal midbrain and can be a hallmark of Parinaud's syndrome, a condition that affects the ability of the eyes to move properly, especially in the vertical direction. | '''Collier's sign''', also known as the '''posterior fossa stare''' or '''tucked lid sign''', is a clinical sign that indicates a dysfunction in the midbrain, particularly involving the structures responsible for vertical gaze. This sign is characterized by bilateral eyelid retraction, giving the appearance of a fixed and wide-eyed stare. It is often associated with lesions in the dorsal midbrain and can be a hallmark of Parinaud's syndrome, a condition that affects the ability of the eyes to move properly, especially in the vertical direction. | ||
==Etiology== | ==Etiology== | ||
Collier's sign can be caused by various conditions that affect the midbrain, including [[stroke]], [[tumors]], [[multiple sclerosis]], and [[hydrocephalus]]. The midbrain contains crucial structures for vertical eye movement, and damage to these areas can lead to the characteristic eyelid retraction seen in Collier's sign. | Collier's sign can be caused by various conditions that affect the midbrain, including [[stroke]], [[tumors]], [[multiple sclerosis]], and [[hydrocephalus]]. The midbrain contains crucial structures for vertical eye movement, and damage to these areas can lead to the characteristic eyelid retraction seen in Collier's sign. | ||
==Pathophysiology== | ==Pathophysiology== | ||
The pathophysiology of Collier's sign involves disruption of the neural pathways in the midbrain that control eyelid position and eye movement. The rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF) and the interstitial nucleus of Cajal (INC) are particularly important in this regard. These nuclei coordinate vertical eye movements and eyelid opening. Lesions in these areas can lead to a loss of coordination between the movements of the eyes and the eyelids, resulting in the retracted eyelids characteristic of Collier's sign. | The pathophysiology of Collier's sign involves disruption of the neural pathways in the midbrain that control eyelid position and eye movement. The rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF) and the interstitial nucleus of Cajal (INC) are particularly important in this regard. These nuclei coordinate vertical eye movements and eyelid opening. Lesions in these areas can lead to a loss of coordination between the movements of the eyes and the eyelids, resulting in the retracted eyelids characteristic of Collier's sign. | ||
==Clinical Presentation== | ==Clinical Presentation== | ||
Patients with Collier's sign may present with a variety of symptoms related to impaired vertical gaze, including difficulty looking up or down, double vision (diplopia), and the distinctive eyelid retraction. This sign is often observed alongside other signs of Parinaud's syndrome, such as convergence-retraction nystagmus and light-near dissociation of the pupils. | Patients with Collier's sign may present with a variety of symptoms related to impaired vertical gaze, including difficulty looking up or down, double vision (diplopia), and the distinctive eyelid retraction. This sign is often observed alongside other signs of Parinaud's syndrome, such as convergence-retraction nystagmus and light-near dissociation of the pupils. | ||
==Diagnosis== | ==Diagnosis== | ||
The diagnosis of Collier's sign is primarily clinical, based on the observation of the characteristic eyelid retraction and associated symptoms. Neuroimaging, such as [[MRI]] or [[CT scan]], may be used to identify the underlying cause of the midbrain dysfunction, such as a tumor or stroke. | The diagnosis of Collier's sign is primarily clinical, based on the observation of the characteristic eyelid retraction and associated symptoms. Neuroimaging, such as [[MRI]] or [[CT scan]], may be used to identify the underlying cause of the midbrain dysfunction, such as a tumor or stroke. | ||
==Treatment== | ==Treatment== | ||
Treatment of Collier's sign focuses on addressing the underlying cause of the midbrain dysfunction. This may involve surgical intervention for tumors, management of hydrocephalus, or treatment of other conditions like multiple sclerosis. Symptomatic treatment may also be provided to help manage the effects of impaired vertical gaze. | Treatment of Collier's sign focuses on addressing the underlying cause of the midbrain dysfunction. This may involve surgical intervention for tumors, management of hydrocephalus, or treatment of other conditions like multiple sclerosis. Symptomatic treatment may also be provided to help manage the effects of impaired vertical gaze. | ||
==Prognosis== | ==Prognosis== | ||
The prognosis for patients with Collier's sign depends on the underlying cause of the midbrain dysfunction. Early detection and treatment of the cause can improve outcomes, but some patients may have persistent difficulties with vertical gaze and eyelid position. | The prognosis for patients with Collier's sign depends on the underlying cause of the midbrain dysfunction. Early detection and treatment of the cause can improve outcomes, but some patients may have persistent difficulties with vertical gaze and eyelid position. | ||
==See Also== | ==See Also== | ||
* [[Parinaud's syndrome]] | * [[Parinaud's syndrome]] | ||
| Line 24: | Line 30: | ||
* [[Vertical gaze palsy]] | * [[Vertical gaze palsy]] | ||
* [[Neuro-ophthalmology]] | * [[Neuro-ophthalmology]] | ||
[[Category:Neurology]] | [[Category:Neurology]] | ||
[[Category:Ophthalmology]] | [[Category:Ophthalmology]] | ||
[[Category:Signs and symptoms]] | [[Category:Signs and symptoms]] | ||
{{Neurology-stub}} | {{Neurology-stub}} | ||
{{Ophthalmology-stub}} | {{Ophthalmology-stub}} | ||
{{No image}} | {{No image}} | ||
Latest revision as of 02:11, 4 April 2025
| Collier's sign | |
|---|---|
| Synonyms | Collier's tucked lid sign |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Eyelid retraction |
| Complications | N/A |
| Onset | N/A |
| Duration | N/A |
| Types | N/A |
| Causes | Dorsal midbrain syndrome, Parinaud's syndrome, Pineal gland tumor |
| Risks | N/A |
| Diagnosis | Clinical diagnosis |
| Differential diagnosis | Thyroid eye disease, Horner's syndrome |
| Prevention | N/A |
| Treatment | Treatment of underlying cause |
| Medication | N/A |
| Prognosis | Depends on underlying condition |
| Frequency | Rare |
| Deaths | N/A |
Collier's sign, also known as the posterior fossa stare or tucked lid sign, is a clinical sign that indicates a dysfunction in the midbrain, particularly involving the structures responsible for vertical gaze. This sign is characterized by bilateral eyelid retraction, giving the appearance of a fixed and wide-eyed stare. It is often associated with lesions in the dorsal midbrain and can be a hallmark of Parinaud's syndrome, a condition that affects the ability of the eyes to move properly, especially in the vertical direction.
Etiology[edit]
Collier's sign can be caused by various conditions that affect the midbrain, including stroke, tumors, multiple sclerosis, and hydrocephalus. The midbrain contains crucial structures for vertical eye movement, and damage to these areas can lead to the characteristic eyelid retraction seen in Collier's sign.
Pathophysiology[edit]
The pathophysiology of Collier's sign involves disruption of the neural pathways in the midbrain that control eyelid position and eye movement. The rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF) and the interstitial nucleus of Cajal (INC) are particularly important in this regard. These nuclei coordinate vertical eye movements and eyelid opening. Lesions in these areas can lead to a loss of coordination between the movements of the eyes and the eyelids, resulting in the retracted eyelids characteristic of Collier's sign.
Clinical Presentation[edit]
Patients with Collier's sign may present with a variety of symptoms related to impaired vertical gaze, including difficulty looking up or down, double vision (diplopia), and the distinctive eyelid retraction. This sign is often observed alongside other signs of Parinaud's syndrome, such as convergence-retraction nystagmus and light-near dissociation of the pupils.
Diagnosis[edit]
The diagnosis of Collier's sign is primarily clinical, based on the observation of the characteristic eyelid retraction and associated symptoms. Neuroimaging, such as MRI or CT scan, may be used to identify the underlying cause of the midbrain dysfunction, such as a tumor or stroke.
Treatment[edit]
Treatment of Collier's sign focuses on addressing the underlying cause of the midbrain dysfunction. This may involve surgical intervention for tumors, management of hydrocephalus, or treatment of other conditions like multiple sclerosis. Symptomatic treatment may also be provided to help manage the effects of impaired vertical gaze.
Prognosis[edit]
The prognosis for patients with Collier's sign depends on the underlying cause of the midbrain dysfunction. Early detection and treatment of the cause can improve outcomes, but some patients may have persistent difficulties with vertical gaze and eyelid position.
See Also[edit]
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