Bilateral carotid dissection due to Eagle syndrome in a young female

Abstract

Eagle syndrome (ES) is a rare clinical syndrome characterized by the elongation of the temporal bone's styloid process, or calcification of stylohyoid ligament, compressing surrounding structures causing pharyngalgia. One of its variants, the styloid-carotid artery syndrome, produces symptoms by compression of the external or internal carotid arteries (ICA). Here, we present a case of a 43-year-old woman with ES and bilateral ICA dissections. The patient underwent staged bilateral angioplasty and covered stent placement, followed by styloidectomy. A computerized tomography angiogram revealed patency of both stents at a two-year follow-up.

Fracture of a Flow Diverter in the Cervical Internal Carotid Artery Due to Eagle Syndrome

“…Duarte-Celada and colleagues report a case in which elective styloidectomies of the right and then left styloid processes at 5 and 8 months, respectively, were performed after stent placement in a patient with Eagle syndrome initially presenting with bilateral carotid dissection. 12 It remains unclear whether the subsequent removal of the styloid processes was carried out to protect the implanted covered stents or to reduce other symptoms caused by the styloid processes, such as headaches and neck pain. However, the 2-year follow-up computed tomography angiography demonstrated bilateral stent patency.…”

Eagle syndrome and carotid artery dissection: a rare skull base cause of stroke

“…Surgery was generally performed on a semi-elective basis, following initial medical or endovascular management. No recurrent clinical characteristics were noted in those selected for surgical intervention, however, there appears to be a trend for surgical management as a definitive treatment choice in recurrent and/or severe ischaemic disease4–30 (online supplemental table 1).…”

“…Patients with this syndrome can also experience irritation of the sympathetic chain when rotating their neck, causing pain in the distribution of the carotid artery 2. Although more commonly seen in patients with connective tissue disorders and trauma, ICA dissection with acute ischaemic events secondary to stylocarotid Eagle’s syndrome has been described in a growing number of case reports 4–30. These cases share similar clinical presentations, however, given the rarity of the condition, there is no clear consensus on its definitive management.…”

Carotid artery dissection due to elongated styloid process treated by acute phase carotid artery stenting: A case report

“…e elongated styloid process is defined as that longer than 25-30 mm [1,6,13] and it sometimes compresses the cervical nerves or arteries, leading to symptomatic conditions named Eagle's syndrome. Although Eagle's syndrome is famous for being one of the causes of ICA dissection, symptomatic vascular Eagle's syndrome is rarely encountered.…”

“…On the other hand, endovascular treatment was chosen only for seven cases. [1,[4][5][6]10,11,13] Styloid process resection was not chosen as the first-line treatment.…”