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

Selvadurai, Shaun; Williamson, Andrew; Virk, Jagdeep Singh; Clarke, P.

doi:10.1136/bcr-2021-247954

Cited by 7 publications

(5 citation statements)

References 43 publications

(69 reference statements)

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“…e demographic, clinical characteristics, treatment strategies, and follow-up of the patients are summarized in Table 1. [1,2,5,6,10,[14][15][16][18][19][20][21]23,24,27,30,31,37,38,[42][43][44][45][46][47][50][51][52]54,55,57] e mean age of the patients was 48.2 years (range 30-72). In an article, one patient was described as a "teenager" but was not used for statistical evaluation.…”

Section: Resultsmentioning

confidence: 99%

Eagle syndrome: An updated review

Pagano,

Ricciuti,

Mancini

et al. 2023

Surgical Neurology International

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Background: This work aims to review the current literature and our experience on vascular Eagle syndrome (ES) that can present misleading clinical presentations and better understand the possible therapeutic strategies. Methods: We reviewed the existing literature on PubMed from January 1, 2017, to December 31, 2022, including the sequential keywords “vascular AND Eagle syndrome,” “vascular AND styloid syndrome,” “vascular AND elongated styloid process,” “vascular AND stylocarotid syndrome,” and “Eagle syndrome AND carotid artery dissection.” Results: 38 vascular ES cases, including our experience, were analyzed. The most frequent clinical onset was hemiparesis (n 21, 57%), but other regular clinical presentations were aphasia, loss of consciousness, amaurosis, headache, or a combination of the latter. Massive oral bleeding was reported only once in the literature before our case. Twelve patients were treated with only antiplatelet therapy, either single or double. Nine patients were treated with anticoagulation therapy only. In 14 patients, a carotid artery stent was used, associated with anticoagulation or antiplatelet therapy. In 17 cases, a styloid process (SP) resection was performed. Conclusion: ES has many clinical presentations, and carotid artery dissection resulting in oral bleeding seems rare. Literature results and our experience make us believe that when dealing with vascular ES, the best treatment strategy is endovascular internal carotid artery stenting with antiplatelet therapy, followed by surgical removal of the elongated SP to prevent stent fracture.

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Section: Resultsmentioning

confidence: 99%

Eagle syndrome: An updated review

Pagano,

Ricciuti,

Mancini

et al. 2023

Surgical Neurology International

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“…5,16 Dissection can occur in younger patients without other risk factors for dissection, as in our case. 3,32,33 Compression of the carotid vessels can also affect the sympathetic nerves that travel on those vessels, leading to symptoms of Horner's syndrome, which can improve following styloidectomy. 24,34 A review of the literature revealed 15 cases of ICA dissection due to Eagle syndrome, which were treated with styloidectomy (Table 1).…”

Section: Observationsmentioning

confidence: 99%

“…24,34 A review of the literature revealed 15 cases of ICA dissection due to Eagle syndrome, which were treated with styloidectomy (Table 1). 1,3,4,7,14,15,20,24,[32][33][34][35] The median age at presentation was 46 years (interquartile range 41-55 years), and 11 (73%) of 15 patients were male. Three cases noted possible triggers, two of which were related to neck motion, whereas the third case occurred in a patient with a recent tooth extraction with tonsillar swelling.…”

Section: Observationsmentioning

confidence: 99%

“…4,14,24 Symptoms at presentation varied and included headache, odynophagia, dysarthria, dizziness, and Horner's syndrome, as well as focal neurological deficits such as hemiparesis, hemineglect, and visual field deficits. 1,4,7,15,33 No cases reported recent head trauma. Of the 11 cases that reported a surgical approach, all used the external or transcervical approach.…”

Section: Observationsmentioning

confidence: 99%

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Surgical management of stylocarotid Eagle syndrome in a patient with bilateral internal carotid artery dissection: illustrative case

Vigilante,

Khalife,

Badger

et al. 2024

Journal of Neurosurgery: Case Lessons

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BACKGROUND Eagle syndrome is characterized by an elongated styloid process, which can cause acute neurological symptoms when the projection impinges on local structures. One method by which Eagle syndrome can cause acute stroke is via internal carotid artery dissection. OBSERVATIONS A patient presented with acute aphasia and right-arm weakness. Imaging revealed a left internal carotid artery dissection, which was treated with stenting. Three years later, the patient presented with left-sided weakness, and imaging revealed a new right internal carotid artery dissection. Closer review of the patient’s imaging revealed bilateral elongated styloid processes. The patient subsequently underwent staged bilateral styloidectomy and returned to his prior baseline postoperatively. LESSONS This case report describes a patient with Eagle syndrome who had two internal carotid artery dissections separated by several years. A literature review revealed that styloidectomy is well tolerated in patients with carotid dissection due to Eagle syndrome. Patients with carotid dissection due to Eagle syndrome remain at risk for contralateral dissection, and prophylactic contralateral styloidectomy should be considered.

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“…Of 34 cases reported in the literature since the millennium, only a single case of symptomatic SCS in a pediatric patient has been reported. 29…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Mechanical disorders of the cervicocerebral circulation in children and young adults

Baranoski,

White,

Chung

et al. 2023

J NeuroIntervent Surg

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Mechanical disorders of the cervicocerebral circulation (MDCC) are conditions in which neurological symptoms result from a disturbance of cerebral blood flow attributable to external mechanical forces exerted on extracranial blood vessels by adjacent musculoskeletal structures during head movement that is presumably within a physiological range. The disease spectrum includes bow hunter’s syndrome, carotid-type Eagle syndrome, and various dynamic venous compression syndromes. These conditions have distinct phenotypes in children which differ from those expressed in older adults. In contemporary practice, recognition and diagnostic evaluation is the domain of the neuroendovascular specialist. The diagnostic evaluation of MDCC involves significant technical nuance that can be critical to directing appropriate management, particularly in children. This report aims to provide a comprehensive overview of the pathophysiology, anatomical patterns, diagnosis, and treatment for the full spectrum of MDCC that is commonly encountered in clinical practice.

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

Cited by 7 publications

References 43 publications

Eagle syndrome: An updated review

Eagle syndrome: An updated review

Surgical management of stylocarotid Eagle syndrome in a patient with bilateral internal carotid artery dissection: illustrative case

Mechanical disorders of the cervicocerebral circulation in children and young adults

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