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2015 ; 2
(1
): 21-25
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Carotid Artery Dissection Caused by an Elongated Styloid Process: Three Case
Reports and Review of the Literature
#MMPMID28663957
Ogura T
; Mineharu Y
; Todo K
; Kohara N
; Sakai N
NMC Case Rep J
2015[Jan]; 2
(1
): 21-25
PMID28663957
show ga
Eagle syndrome is a set of symptoms associated with an elongated styloid process.
Although it is an important cause of cerebrovascular complications such as
carotid artery dissection (CAD) or thromboembolism, the condition may be
underdiagnosed. We treated three patients with CAD caused by an elongated styloid
process within a year. The first patient was a 55-year-old man who developed
recurrent thromboembolism despite anticoagulation therapy. Computed tomography
(CT) angiography showed bilateral CAD with tips of styloid processes attached to
the dissected lesions. He underwent surgical resection of the styloid process
followed by carotid artery stenting. The second patient was also a 55-year-old
man who developed acute stroke due to carotid artery occlusion, and underwent
thrombectomy and carotid artery stenting. Both these patients experienced
resolution of their neurological symptoms and had no recurrence of stroke. The
third patient was an 80-year-old man with an asymptomatic dissecting aneurysm of
the cervical internal carotid artery. He had a history of odynophagia and
underwent surgical resection of the styloid process, with resolution of his
symptoms. These cases, taken together with recent evidences showing that CAD was
associated with the styloid process length, suggest that Eagle syndrome may not
be an uncommon cause of CAD. Examination by CT angiography is important to avoid
misdiagnosis. A literature review indicates that some cases were refractory to
anticoagulation and surgical resection of the elongated styloid process or
carotid artery stenting could be a treatment option to prevent further stroke.