scholarly journals Internal carotid dissection caused by an elongated styloid process (Eagle syndrome)

2013 ◽  
Vol 2013 (jun11 1) ◽  
pp. bcr2013009878-bcr2013009878 ◽  
Author(s):  
O. Sveinsson ◽  
N. Kostulas ◽  
L. Herrman
Keyword(s):  
Internal Carotid ◽  
Styloid Process ◽  
Carotid Dissection ◽  
Elongated Styloid Process ◽  
Eagle Syndrome

Compression of the cervical internal carotid artery by the stylopharyngeus muscle: an anatomical study with potential clinical significance

2010 ◽  
Vol 113 (4) ◽  
pp. 881-884 ◽  
Author(s):  
R. Shane Tubbs ◽  
Marios Loukas ◽  
Joshua Dixon ◽  
Aaron A. Cohen-Gadol
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Anatomical Study ◽  
Styloid Process ◽  
Elongated Styloid Process ◽  
Eagle Syndrome ◽  
Definition Of ◽  
Ica Stenosis ◽  
The Relationship

Object Occasionally, the internal carotid artery (ICA) may be symptomatically compressed in the neck by an elongated styloid process. The authors are unaware, however, of any study to date in which the aim was to describe the compression of this part of the ICA by surrounding muscles extending from the styloid process. Methods In 20 adult cadavers (40 sides), dissection of the cervical ICA was performed, with special attention given to the relationship between this artery and the stylopharyngeus muscle. In addition, rotation of the head was performed while observing for any compression of the ICA by this muscle. Last, the segment of the ICA immediately adjacent to the stylopharyngeus was excised and evaluated for signs of gross compression. Results Five sides (12.5%) were found to have an ICA that was grossly compressed by the neighboring stylopharyngeus muscle, and this was confirmed on excised ICA specimens. Moreover, such compression was increased with ipsilateral rotation of the head. Effacement of the lumen of the ICA by the stylopharyngeus ranged from approximately 30 to 50%. Such compression was increased by approximately 25% with ipsilateral rotation of the head. Conclusions To the authors' knowledge, compression of the cervical ICA by the stylopharyngeus muscle has not been previously described. Such a relationship should be appreciated by the clinician who treats patients with symptoms of ICA stenosis or occlusion as a potential extracranial site of compression. Based on this study, a subset of patients with occlusion of the cervical ICA but without elongation of the styloid process should be included within the definition of Eagle syndrome.

scholarly journals Dynamic assessment of internal carotid artery and elongated styloid process in a case of bilateral carotid artery dissection

2020 ◽  
Vol 11 ◽  
pp. 163
Author(s):  
Yoshinobu Horio ◽  
Kenji Fukuda ◽  
Koichi Miki ◽  
Noriko Hirao ◽  
Mitsutoshi Iwaasa ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Dynamic Assessment ◽  
Head Rotation ◽  
Styloid Process ◽  
Artery Dissection ◽  
Elongated Styloid Process ◽  
Bilateral Carotid ◽  
Eagle Syndrome

Background: Vascular Eagle syndrome is that an elongated styloid process causes ischemic stroke due to internal carotid artery (ICA) dissection. Dynamic assessment using radiological imaging has not been well investigated. We assessed the change in the relative positional relationship between the elongated styloid process and the ICA using a cone-beam computed tomography (CBCT). Case Description: A 46-year-old female presenting with disturbance of consciousness, right hemiparesis, and aphasia was admitted to our hospital. Initial CT analysis showed a bilateral elongated styloid process. Magnetic resonance angiography (MRA) showed occlusion of the left ICA and a near occlusion of the right ICA. MRA also revealed the intimal flap and intramural hematoma in the bilateral ICA. Digital subtraction angiography showed bilateral ICA occlusion and carotid artery stenting was performed subsequently. After that, we visualized the movement of carotid stent with CBCT fusion methods. The stent moved forward and backward at the attachment point of the styloid process during head rotation, and there was a possibility that mechanical stress was emphasized at this point. Styloidectomy was performed after her rehabilitation. The patient did not experience a recurrence of stroke. Conclusion: We showed that repeated attachment of the styloid process and ICA may trigger an ICA dissection during head rotation. This finding would be helpful for understanding the causes of vascular Eagle syndrome.

scholarly journals Eagle syndrome as a rare cause of recurrent transient ischemic stroke in Senegal (West Africa)

2021 ◽  
Vol 7 (9) ◽  
pp. 1534
Author(s):  
Birame Loum ◽  
Cheikh Ahmedou Lame ◽  
Cheikhna B. Ndiaye ◽  
Kamadore Toure ◽  
Mouhamadou Mansour Ndiaye
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Rare Condition ◽  
Styloid Process ◽  
Neurological Impairment ◽  
Vascular Events ◽  
Eagle Syndrome

<p>Eagle syndrome is a rare condition, often characterized by nonspecific symptoms. It is due to an abnormally long or compressive styloid process on surrounding structures. Exceptionally, it can cause neuro-vascular manifestations. We report an observation of Eagle syndrome discovered incidentally in presence of recurrent transient ischemic stroke. A 74-year-old man with no cardiovascular risk factors, was admitted to our department following 4 episodes of transient ischemic stroke with right hemiplegia and aphasia, always rapidly resolving. Head and neck CT scan showed 2 long styloid processes with a marked impingement of the left one against the ipsilateral internal carotid artery. Intraoral styloidectomy was performed. The patient recovered fully and remained free of symptoms without neurological impairment, at 6 months. Eagle syndrome is a rare condition which may lead, exceptionally, to repetitive transient ischemic stroke. Surgical styloidectomy must be considered to reduce the risk of new vascular events and prevent serious complications such as dissection of the internal carotid artery.</p>

Entrapment of the glossopharyngeal nerve in patients with Eagle syndrome: surgical technique and outcomes in a series of 5 patients

2009 ◽  
Vol 111 (6) ◽  
pp. 1226-1230 ◽  
Author(s):  
John H. Shin ◽  
Sebastian R. Herrera ◽  
Paula Eboli ◽  
Sabri Aydin ◽  
Emad H. Eskandar ◽  
...  
Keyword(s):  
Pain Relief ◽  
Medical Center ◽  
Pain Syndrome ◽  
Styloid Process ◽  
Glossopharyngeal Nerve ◽  
Surgical Morbidity ◽  
Elongated Styloid Process ◽  
Operative Indications ◽  
Eagle Syndrome ◽  
The Many

Object Eagle syndrome is characterized by unilateral pain in the oropharynx, face, and earlobe, and is caused by an elongated styloid process or ossification of the stylohyoid ligament with associated compression of the glossopharyngeal nerve. The pain syndrome may be successfully treated with surgical intervention that involves resection of the styloid process. Although nerve decompression is routinely considered a neurosurgical intervention, Eagle syndrome and its treatment are not sufficiently examined in the neurosurgical literature. Methods A review was performed of cases of Eagle syndrome treated in the Department of Neurosurgery at the University of Illinois at Chicago Medical Center over the last 7 years. The clinical characteristics, radiographic imaging, operative indications, procedural details, surgical morbidity, and clinical outcomes were collected and analyzed. Results Of the many patients with facial pain treated between 2001 and 2007, 7 were diagnosed with Eagle syndrome, and 5 of these patients underwent resection of the elongated styloid process. There were 4 women and 1 man, ranging in age from 20 to 68 years (mean 43 years). The average duration of disease was 11 years. In all patients, a preoperative workup revealed unilateral or bilateral elongation of the styloid process. All patients underwent resection of the styloid process on the symptomatic side using a lateral transcutaneous approach. There were no surgical complications. All patients experienced pain relief immediately after the operation. At the latest follow-up (average 46 months, range 7 months to 7.5 years) all but 1 patient maintained complete pain relief. In 1 patient, the pain recurred 12 months postoperatively and additional interventions were required. Conclusions Eagle syndrome may be considered an entrapment syndrome of the glossopharyngeal nerve. It is a distinct clinical entity that should be considered when evaluating patients referred for glossopharyngeal neuralgia. The authors' experience indicates that patients with Eagle syndrome may be successfully treated using open resection of the elongated styloid process, which appears to be both safe and effective in terms of long-lasting pain relief.

scholarly journals A Case of a Very Elongated Styloid Process

2017 ◽  
Vol 10 ◽  
pp. 117955061772889
Author(s):  
YaLi Liu ◽  
Huaian Yang ◽  
Xiangguo Cui
Keyword(s):  
Treatment Process ◽  
Styloid Process ◽  
Chief Complaint ◽  
Chinese Woman ◽  
Recurrent Pain ◽  
Elongated Styloid Process ◽  
Frequent Episodes ◽  
Intraoral Approach ◽  
Eagle Syndrome ◽  
Stylohyoid Ligament

Eagle syndrome is characterized by recurrent pain in the oropharynx and face due to an elongated styloid process or calcified stylohyoid ligament. In this article, we experienced a case of an elongated styloid process which is very rare in size and detailed treatment process. The patient was a 53-year-old Chinese woman with a chief complaint of frequent episodes of radiating pain in left preauricular region for 2 years. An intraoral approach was chosen to shorten part of her styloid process, and the chief complaint disappeared immediately after the operation.

scholarly journals Recurrence of internal carotid artery dissection associated with elongated styloid process: A case report

2021 ◽  
Vol 12 ◽  
pp. 473
Author(s):  
Shigeomi Yokoya ◽  
Hidesato Takezawa ◽  
Hideki Oka ◽  
Akihiko Hino
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Styloid Process ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Elongated Styloid Process ◽  
Initial Onset ◽  
Long Term Follow Up ◽  
Ischemic Attack

Background: An elongated styloid process is known to cause ischemic stroke. Previous reports claim that internal carotid artery (ICA) dissection due to the elongated styloid process has good outcomes when treated conservatively; however, long-term follow-up has not been attempted and recurrence in the later period has not been reported so far. We report a case of recurrence of symptoms over a decade after the initial onset. Case Description: A 59-year-old man experienced a transient ischemic attack (TIA) 10 years ago. Six years ago, he experienced hemispheric TIA, and magnetic resonance angiography revealed a diminished signal of the left ICA; however, no further examination was performed. Four years ago, he experienced another transient amaurosis attack and was treated with antiplatelet therapy because no embolic source was detected using ultrasonography examination, and he was diagnosed with idiopathic ICA dissection. Recently, he experienced a third amaurosis fugax attack. Digital subtraction angiography and cone-beam computed tomography demonstrated left cervical ICA dissection due to elongated styloid process. He underwent surgical resection of the left styloid process and cervical stent placement. He had no ischemic attacks postoperatively. Conclusion: The elongated styloid process may cause recurrent ischemic attacks over a decade due to ICA dissection.

scholarly journals Relato de caso: Dissecção Carotídea associada a Síndrome de Eagle

2021 ◽  
Author(s):  
Vinícius de Queiroz Aguiar ◽  
Gustavo Sales França ◽  
Bernardo Costa Berriel Abreu ◽  
Talles Henrique Caixeta ◽  
Alexandre Henrique de Azevedo Dias ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Clinical Manifestations ◽  
Styloid Process ◽  
Left Internal Carotid Artery ◽  
Partial Recovery ◽  
Body Sensation ◽  
Eagle Syndrome ◽  
Vessel Dissection

Context: Eagle syndrome is characterized by the elongation or disfiguration of the styloid process, which leads to a range of clinical manifestations resulting from the structures that are affected by the prolongation of the bone, and the classic presentation is composed of pain and foreign body sensation in the throat, otalgia, and dysphagia. Case report: We describe the case of a 60-year-old man with an ischemic stroke due to dissection of the left internal carotid artery, associated with compression resulting from Eagle syndrome. At clinical presentation, the patient presented right hemiparesis and severe dysphagia, with NIH=18, characterizing the stroke. An angiotomography of the skull and brain was performed, which showed an image compatible with dissection of the left internal carotid artery from the prolongation of the styloid process, characterizing Eagle syndrome stylocarotid syndrome. The patient was submitted to thrombolysis with rt-PA, presenting a partial response, and surgical bone reduction. Patient evolved with partial recovery, with NIH=10, and, at the time of discharge, presented RANKIN 1, symptoms without disabilities. Conclusion: The Eagle syndrome, while it occurs more frequently in women, in general, with the classic presentation, can evolve with a more severe picture, associated with vessel dissection and brain involvement.

scholarly journals Eaglov sindrom

2017 ◽  
Vol 86 ◽  
Author(s):  
Mladen Gasparini ◽  
Primož Praček ◽  
Jani Muha ◽  
Uroš Tomić
Keyword(s):  
Average Length ◽  
Cranial Nerves ◽  
Styloid Process ◽  
Computed Tomographic Angiography ◽  
Measurement Tool ◽  
Computed Tomographic ◽  
Elongated Styloid Process ◽  
Eagle Syndrome ◽  
The Right ◽  
Tomographic Angiography

Background: In the present article we present the characteristics of Eagle syndrome, which is an often overlooked cause of chronic pain in the neck and head. The syndrome is caused by the compression of an elongated styloid process on the adjacent cranial nerves or the carotid arteries. Since there are disparate data in the literature regarding the proportion of people with an elongated styloid process, we conducted a survey to determine the percentage of patients with an elongated styloid process in a group of subjects who underwent computed tomographic imaging of the neck vessels in our institution.Methods: We analyzed the images of 104 patients who were referred to our institution for computed tomographic angiography of the neck between the years 2014 and 2016. With the help of a software measurement tool, we determined the length of the styloid processes and compared the length of the processes on both sides and in both genders. Patients with an elongated styloid process were reviewed for any symptoms of Eagle syndrome.Results: The average age of the reviewed patients was 67.1 years. Both genders were equally represented (51 % men and 49 % women). The average length of the styloid process was 23.8 (7.0) mm, with 23 patients (22.1 %) having a styloid process longer than 30 mm. In one third of those patients the styloid process was elongated bilaterally. There were no differences in the average length of the styloid process between men and women and between the left and the right side. Among patients with an elongated styloid process, only one (4.3 %) had symptoms attributable to the Eagle syndrome.Conclusions: Eagle syndrome should be suspected in a patient with repetitive, dull pain in the throat and neck, which worsens during speaking, chewing or swallowing. The diagnosis is confirmed by computed tomography which could demonstrate an elongated styloid process and exclude other causes for neck pain. With regard to the results of our study, an elongated styloid process is found in a relatively high percentage of patients but the condition is only rarely symptomatic.

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