Eagle syndrome: A case report with internal carotid artery d
Eagle syndrome was first described in 1937 by the otolaryngologist, Watt W. Eagle, as an elongated styloid process or calcified stylohyoid ligament associated with symptoms related to compression of local structures.

Stylocarotid syndrome, the less common vascular variant of Eagle syndrome, is characterized with symptoms of headache, transient ischemic attack (TIA), or stroke. A rare complication of Stylocarotid syndrome, 'Carotid artery dissection' is presented in the case below.

Case background:

A 60-year-old obese man with a past medical history of seizures, poorly controlled insulin-dependent diabetes, controlled hypertension, and an approximately 45-year history of smoking cigarettes was presented to the emergency department because of sudden onset of right retro-auricular pain, severe bifrontal headache, left arm and leg paresthesia and weakness, and transient slurred speech for approx. 1 hour.

Neurological examination revealed an initial stroke.

The patient suffered recurrent transient stroke symptoms next day and CT of the head revealed new right parietal lobe infarct.

On the 6th day, the patient experienced a sudden onset of right retro-auricular pain, headache, and recurrent increase in left arm weakness and numbness. Because of recurrent infarcts even on medical treatment, the decision was made to proceed with stenting of the right ICA dissection.

Discussion:

- Stylocarotid syndrome is a rare vascular variant of Eagle syndrome.
- Symptoms ranging from headache to TIA or stroke as a result of the elongated styloid process impinging on the ICA or external carotid artery
- Carotid artery dissection, a rare complication of the Stylocarotid syndrome, may result from direct mechanical insult by an elongated styloid process
- Factors behind spontaneous carotid artery dissections include smoking, trauma, underlying connective tissue or vascular disorder, and possibly history of migraines and hypertension
- There are no treatment guidelines for Eagle syndrome with carotid dissection
- CT imaging is of prime importance in the diagnosis of the Stylocarotid syndrome
- Medical judgment plays an important role in evaluating treatment options

Read the entire case here: https://pxmd.co/CEylp
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