Abstract:Idiopathic carotidynia (IC) is a rare and poorly understood syndrome consisting of unilateral neck pain, tenderness, and increased pulsations over the affected carotid bifurcation. A growing body of evidence supports the hypothesis that IC is a distinct clinicopathologic entity with characteristic imaging features. We report the case of a 34-year-old Caucasian male presenting with intense unilateral neck pain in the emergency setting. Computed tomography and ultrasonography revealed fusiform eccentric thickeni… Show more
“…However, the cause of the inflammatory process is unknown. In line with some of the previously reported cases, the laboratory markers of inflammation were normal in our patient [14,15].…”
Section: Discussionsupporting
confidence: 93%
“…Similar to the earlier case reports, the patient responded to anti-inflammatory medications [7,8,12,14,15].…”
Section: Discussionsupporting
confidence: 86%
“…Cross-sectional imaging plays a major role in diagnosing other vascular conditions mimicking IC, such as giant cell arteritis, thrombosis, fibromuscular dysplasia, carotid dissection, aneurysm, lymphadenitis, submandibular gland disease, cervical arthrosis, and neck cancer [7,15,18,19]. A contrast-enhanced MRI performed in our patient during his first episode of right-sided symptoms, delineated the characteristic perivascular inflammation around the affected carotid arteries, and excluded the other ominous causes of neck pain.…”
Section: Discussionmentioning
confidence: 65%
“…In cases of IC, a characteristic abnormal soft tissue surrounding the symptomatic carotid bifurcation has been previously reported on various imaging techniques like ultrasound (US), magnetic resonance imaging (MRI), CT imaging, CT angiography, and [18F] fluoro-deoxy-glucose positron-emission tomography-CT [5,7,8,13,[15][16][17][18][19][20][21]. Several studies have documented the role of ultrasound in the preliminary diagnosis of IC [14,16,17,19].…”
Idiopathic carotidynia (IC) is a rare, possibly under-diagnosed clinico-radiologic entity that consists of acute unilateral neck pain and tenderness over the carotid bifurcation. Lecler et al. have recently described this condition associated with characteristic imaging features of transient perivascular soft tissue inflammation at the level of the affected carotid bifurcation, by a new term TIPIC (transient perivascular inflammation of the carotid artery) syndrome. We report the case of an Indian man, with recurrent right-sided TIPIC syndrome and past history of transient left-sided symptoms. On initial presentation, the clinical history, ultrasound (US) features, magnetic resonance imaging (MRI) findings, and laboratory investigations of the patient were correlated to establish the diagnosis of TIPIC syndrome. Doppler US was performed for imaging follow-up of this patient, when he presented again with recurrence of similar symptoms of right neck pain. In this 45-year-old patient, US demonstrated a characteristic perivascular echogenic soft tissue around the symptomatic carotid artery. MRI confirmed these imaging findings and ruled out carotid dissection. Patient responded to antiinflammatory medications. Recurrence and resolution of the soft tissue thickening surrounding the affected carotid arteries were documented on serial follow-up US examinations. This case report illustrates that US can be effectively used in the diagnosis as well as follow-up of TIPIC syndrome.
“…However, the cause of the inflammatory process is unknown. In line with some of the previously reported cases, the laboratory markers of inflammation were normal in our patient [14,15].…”
Section: Discussionsupporting
confidence: 93%
“…Similar to the earlier case reports, the patient responded to anti-inflammatory medications [7,8,12,14,15].…”
Section: Discussionsupporting
confidence: 86%
“…Cross-sectional imaging plays a major role in diagnosing other vascular conditions mimicking IC, such as giant cell arteritis, thrombosis, fibromuscular dysplasia, carotid dissection, aneurysm, lymphadenitis, submandibular gland disease, cervical arthrosis, and neck cancer [7,15,18,19]. A contrast-enhanced MRI performed in our patient during his first episode of right-sided symptoms, delineated the characteristic perivascular inflammation around the affected carotid arteries, and excluded the other ominous causes of neck pain.…”
Section: Discussionmentioning
confidence: 65%
“…In cases of IC, a characteristic abnormal soft tissue surrounding the symptomatic carotid bifurcation has been previously reported on various imaging techniques like ultrasound (US), magnetic resonance imaging (MRI), CT imaging, CT angiography, and [18F] fluoro-deoxy-glucose positron-emission tomography-CT [5,7,8,13,[15][16][17][18][19][20][21]. Several studies have documented the role of ultrasound in the preliminary diagnosis of IC [14,16,17,19].…”
Idiopathic carotidynia (IC) is a rare, possibly under-diagnosed clinico-radiologic entity that consists of acute unilateral neck pain and tenderness over the carotid bifurcation. Lecler et al. have recently described this condition associated with characteristic imaging features of transient perivascular soft tissue inflammation at the level of the affected carotid bifurcation, by a new term TIPIC (transient perivascular inflammation of the carotid artery) syndrome. We report the case of an Indian man, with recurrent right-sided TIPIC syndrome and past history of transient left-sided symptoms. On initial presentation, the clinical history, ultrasound (US) features, magnetic resonance imaging (MRI) findings, and laboratory investigations of the patient were correlated to establish the diagnosis of TIPIC syndrome. Doppler US was performed for imaging follow-up of this patient, when he presented again with recurrence of similar symptoms of right neck pain. In this 45-year-old patient, US demonstrated a characteristic perivascular echogenic soft tissue around the symptomatic carotid artery. MRI confirmed these imaging findings and ruled out carotid dissection. Patient responded to antiinflammatory medications. Recurrence and resolution of the soft tissue thickening surrounding the affected carotid arteries were documented on serial follow-up US examinations. This case report illustrates that US can be effectively used in the diagnosis as well as follow-up of TIPIC syndrome.
The complex anatomy of the carotid space within a small confined area is unique to the head and neck and allows for a vast array of pathology. This paper will review the anatomy of the carotid space from the skull base to the thorax, defining its borders at multiple levels, as well as its contents. The paper will also describe the myriad of mass lesions and vascular pathologies that may occur within the carotid space. The discussion will include anatomic considerations in differential diagnoses, imaging features, and lesion characteristics across multiple imaging modalities including CT, MRI, ultrasound, and conventional angiography. Entities discussed include paragangliomas, nerve sheath tumors, meningioma, fibromuscular dysplasia, carotidynia, thrombus, dissection, pseudoaneurysm, and pathology of the deep cervical chain lymph nodes. Understanding the complex and unique anatomy of the carotid space, as well as the nuances of navigating a broad differential, will empower the reader to make an accurate diagnosis.
Transient perivascular inflammation of the carotid artery (TIPIC) syndrome is a rare cause of atypical neck pain. The etiology of TIPIC is not fully known and is characterized by transient inflammation around the carotid artery. Ultrasonography (US) and especially magnetic resonance imaging (MRI) are the most important evaluation methods in the diagnosis and follow‐up of the disease. In this article, we report a 25‐year‐old male patient who presented with unilateral neck pain and was diagnosed with TIPIC in the light of his clinical and radiological findings.
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