Stylocarotid Syndrome Causing Middle Cerebral Artery Infarction

Ramadan, Shadi M

doi:10.4997/jrcpe.2021.414

Cited by 3 publications

(1 citation statement)

References 6 publications

(8 reference statements)

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“…Unfortunately, our patient too developed a malignant middle cerebral artery infarct but recovered well after craniectomy, although he required extensive rehabilitation [11,12].…”

Section: Discussionmentioning

confidence: 79%

Malignant Middle Cerebral Artery Infarct Caused by Eagle’s Syndrome

Sarwar,

Furrukh,

Tabrez

et al. 2023

Cureus

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Eagle's syndrome is characterised by elongation of the styloid process. The elongated styloid process can cause symptoms like dysphagia, facial or neck pain, syncope, visual changes, etc. In severe cases, it may cause a rupture or dissection of the carotid artery, which can lead to intracranial thrombo-embolism and ischemic stroke. We report a case of a 57-year-old male presenting with dysarthria and mild left-sided body weakness. An initial non-contrast computed tomography (CT) scan showed a possible right internal carotid artery thrombus. He developed worsening left-sided weakness and gaze palsy one day after the admission. Repeated CT brain and intracranial angiography were arranged, which showed significant oedema with mass effect and right internal carotid artery dissection with thrombus. He underwent decompressive craniectomy. An enlarged styloid process measuring 4.53 cm in close proximity to the cervical vasculature was also noted. He was not deemed an appropriate candidate for styloidectomy. Due to residual left-sided weakness, he had to take early retirement. He underwent extensive rehabilitation and was able to mobilize with the help of a quad stick after a period of nine months. At the five-year follow-up, there were no characteristic symptoms of Eagle's syndrome and he was mobilizing without support.

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“…Unfortunately, our patient too developed a malignant middle cerebral artery infarct but recovered well after craniectomy, although he required extensive rehabilitation [11,12].…”

Section: Discussionmentioning

confidence: 79%

Malignant Middle Cerebral Artery Infarct Caused by Eagle’s Syndrome

Sarwar,

Furrukh,

Tabrez

et al. 2023

Cureus

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Ischemic stroke due to stylocarotid artery syndrome: a case report and review

Liu,

Li,

Zheng

et al. 2024

J Int Med Res

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Stylocarotid artery syndrome (SAS) is a rare variant of Eagle’s syndrome that may lead to transient ischemic attack or stroke. The underlying pathophysiological mechanism involves compression of the internal carotid artery by an elongated styloid process (ESP), potentially resulting in vascular occlusion or dissection. An ESP exceeding 2.5 cm is deemed elongated, with a length of 3.0 cm considered clinically significant. Although the prevalence of ESP ranges from 4.0% to 7.3%, symptomatic cases are rare; symptoms are present in only approximately 4.0% of individuals with an ESP. Unlike the typical symptoms of Eagle’s syndrome, SAS may not cause pharyngeal discomfort, the sensation of a foreign body in the throat, dysphagia, or facial pain. This absence of characteristic symptoms as well as the development of central nervous system symptoms often leads patients to seek care from neurologists instead of otolaryngologists, increasing the likelihood of misdiagnosis or underdiagnosis. We herein report a unique case of ischemic stroke caused by SAS and present a literature review on cases of SAS-associated ischemic stroke published in the past decade. The reporting of this study conforms to the CARE guidelines.

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Styloid Jugular Nutcracker: The Possible Role of the Styloid Process Spatial Orientation—A Preliminary Morphometric Computed Study

et al. 2023

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Styloid Jugular Nutcracker (SJN, also known as Eagle Jugular Syndrome EJS) derives from a jugular stenosis caused by an abnormal styloid process, compressing the vessel in its superior portion (J3) against the C1 anterior arch. It could be considered a venous vascular variant of Eagle Syndrome (ES). Main clinical features of this ES variant are headache, pulsatile tinnitus and dizziness, possibly related to venous hypertension and impaired cerebral parenchyma drainage. In our opinion, conceptually, it is not the absolute length of the styloid bone that defines its abnormality, but its spatial direction. An elongated bone pointing outward far away from the midline could not compress the vein; vice versa, a short styloid process tightly adherent to the cervical spine could be pathological. To prove this hypothesis, we developed a semi-automatic software that processes CT-Angio images, giving quantitative information about distance and direction of the styloid process in three-dimensional space. We compared eight patients with SJN to a sample of healthy subjects homogeneous for sex and age. Our results suggest that SJN patients have a more vertically directed styloid, and this feature is more important than the absolute distance between the two bony structures. More studies are needed to expand our sample, including patients with the classic and carotid variants of Eagle Syndrome.

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Stylocarotid Syndrome Causing Middle Cerebral Artery Infarction

Cited by 3 publications

References 6 publications

Malignant Middle Cerebral Artery Infarct Caused by Eagle’s Syndrome

Malignant Middle Cerebral Artery Infarct Caused by Eagle’s Syndrome

Ischemic stroke due to stylocarotid artery syndrome: a case report and review

Styloid Jugular Nutcracker: The Possible Role of the Styloid Process Spatial Orientation—A Preliminary Morphometric Computed Study

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