Carotidynia after anticancer chemotherapy

Carotidynia in high-altitude travelers

“…Despite the controversy regarding the precise diagnostic criteria of carotidynia, many researchers have described carotidynia as an idiopathic inflammatory process confined to the distal common carotid artery. 2,4 The presentations of both patients in our report were similar which included exposure to a high-altitude environment with a resultant acute onset of neck pain overlying the carotid artery. Both of their symptoms resolved within two weeks after leaving the high-altitude environment.…”

Idiopathic Carotidynia

“…There has been much controversy in the medical literature about whether idiopathic carotidynia should be regarded as a distinct disease process or merely a symptom of other etiologies of neck pain. [2][3][4][5][6][7][8][9][10][11][12] Much of the confusion arises from the use of the term carotidynia by different practitioners to refer to either the idiopathic disease recognized by the IHS or only to the symptom of pain localized to the carotid artery. Carotidynia, as a symptom, may arise secondary to various vascular and nonvascular causes.…”

“…[5][6][7][8][9][10][11] Furthermore, the typical radiographic pattern of amorphous-enhancing soft tissue surrounding the carotid artery without luminal compromise and with normal blood flow found in patients suffering from idiopathic carotidynia gives validity to the concept that carotidynia represents a distinct inflammatory process of carotid origin. [5][6][7][8][9][10][11] For instance, Amaravadi and colleagues used CT angiography, MRI, and PET-CT as complementary studies in excluding multiple causes of unilateral neck pain in their patient with carotidynia. 8 Having excluded the major differential diagnoses of carotid pain, they concluded that the findings best supported a clinically distinct disease characterized by focal inflammation around the carotid artery.…”

“…The cause of this inflammatory process remains to be established; however, etiological theories include carotid inflammation due to the extension of inflammation from contiguous tissues, a reaction to certain drugs, including chemotherapeutics, and a variant of large-vessel vasculitis. 5,6,14 Regardless of etiology, idiopathic carotidynia appears to be a self-limiting process that responds well to treatment with nonsteroidal anti-inflammatory drugs or a brief course of steroids in more severe cases. [5][6][7]9 Conclusion Idiopathic carotidynia represents a distinct pathological entity with characteristic radiological findings, including perivascular inflammation, normal blood flow, and luminal integrity, that has a self-limiting course and responds well to supportive medical management.…”

“…In fact, various imaging modalities, including magnetic resonance imaging (MRI), computed tomography (CT), ultrasonography, and positron-emission tomography (PET), have demonstrated that there indeed exists a distinct inflammatory process characterized by the presence of amorphous-enhancing soft tissue surrounding the carotid artery in patients with isolated carotidynia without alternate etiologies to account for the symptom. [5][6][7][8][9][10][11] We report the case of a middle-aged woman who presented with sudden-onset right-sided neck pain and imaging studies demonstrating transmural internal carotid artery inflammation. She was treated with low-dose aspirin and ibuprofen, and her symptoms resolved within a week.…”