Giant pseudoaneurysm of the external carotid artery causing stroke: A case report

Budinčević, Hrvoje; Milosevic, Marina; Pavlović, Tomislav

doi:10.1002/jcu.22524

Cited by 8 publications

(4 citation statements)

References 11 publications

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“…The primary database searches yielded 1,940 titles in total and, of those, 876 were assessed relevant for full text review. In total, 285 studies met inclusion criteria for the final review ( Akhaddar et al, 2010 ; Al Weteid & Miloro, 2015 ; Al-Hashim et al, 2017 ; AlAbdulwahed & O’Flynn, 2021 ; Albuquerque et al, 2017 ; Aldakkan et al, 2017 ; Aldelaimi et al, 2017 ; Altun & Camci, 2016 ; Amorim et al, 2017 ; Andrade et al, 2008 ; Anuradha et al, 2020 ; Arntzen, Slowinska & Odeh, 2018 ; Atesci, Karabacakoglu & Gulmez, 2009 ; Avitia, Hamilton & Osborne, 2006 ; Aydin et al, 2018 ; Baba et al, 2017 ; Baez-Martinez et al, 2021 ; Bafaqeeh, 2000 ; Baharudin, Rohaida & Khairudin, 2012 ; Bahgat, Bahgat & Bahgat, 2012 ; Bakshi, 2016 ; Bal et al, 2018 ; Bareiss et al, 2017 ; Becker & Pfeiffer, 2013 ; Bedajit et al, 2014 ; Beder, Ozgursoy & Karatayli Ozgursoy, 2005 ; Beder et al, 2006 ; Bedi et al, 2019 ; Benet-Muñoz et al, 2017 ; Bensoussan, Letourneau-Guillon & Ayad, 2014 ; Bertossi et al, 2014 ; Betances Reinoso et al, 2015 ; Blackett et al, 2012 ; Blythe, Matthews & Connor, 2009 ; Boscainos et al, 2004 ; Bouzaidi et al, 2013 ; Boysen-Osborn & Chin, 2013 ; Brassart et al, 2020 ; Bremmer, Sergent & Ashurst, 2018 ; Buchaim, Buchaim & Shinohara, 2012 ; Budincevic, Milosevic & Pavlovic, 2018 ; Cam, Kocdor & Ozluoglu, 2020 ; Casale et al, 2008 ; Cernea et al, 2007 ; Chang et al, 2015 ; Chauhan et al, 2018 ; Chebbi et al, 2014 ; Chiang et a...…”

Section: Resultsmentioning

confidence: 99%

Neurological phenotypes and treatment outcomes in Eagle syndrome: systematic review and meta-analysis

Hassani,

Grønlund,

Albrechtsen

et al. 2024

PeerJ

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Background Eagle syndrome is caused by an elongated styloid process affecting carotid arteries and cranial nerves. Pain, dysphagia, tinnitus, paresthesia (classic subtype), and neurovascular events (vascular subtype) may be triggered by head movements or arise spontaneously. However, Eagle syndrome remains underappreciated in the neurological community. We aimed to determine the most common neurological and non-neurological clinical presentations in patients with Eagle syndrome and to assess the clinical outcome post-surgical resection in comparison to non-surgical therapies. Methodology We conducted a systematic review of patient-level data on adults with Eagle syndrome, following PRISMA guidelines. We extracted data on demographics, presenting symptoms, neurological deficits, radiological findings, and treatments, including outcomes and complications, from studies in multiple indexing databases published between 2000 and 2023. The study protocol is registered with PROSPERO. Results In total, 285 studies met inclusion criteria, including 497 patients with Eagle syndrome (mean age 47.3 years; 49.8% female). Classical Eagle (370 patients, 74.5%) was more frequent than vascular Eagle syndrome (117 patients, 23.5%, p < 0.0001). Six patients (1.2%) presented with both variants and the subvariant for four patients (0.8%) was unknown. There was a male preponderance (70.1% male) in the vascular subtype. A history of tonsillectomy was more frequent in classic (48/153 cases) than in vascular (2/33 cases) Eagle syndrome (Odds Ratio 5.2, 95% CI [1.2–22.4]; p = 0.028). By contrast, cervical movements as trigger factors were more prevalent in vascular (12/33 cases) than in classic (7/153 cases) Eagle syndrome (Odds Ratio 7.95, 95% CI [2.9–21.7]; p = 0.0001). Headache and Horner syndrome were more frequent in vascular Eagle syndrome and dysphagia and neck pain more prominent in classic Eagle syndrome (all p < 0.01). Surgically treated patients achieved overall better outcomes than medically treated ones: Eighty-one (65.9%) of 123 medically treated patients experienced improvement or complete resolution, while the same applied to 313 (97.8%) of 320 surgical patients (Odds Ratio 1.49, 95% CI [1.1–2.0]; p = 0.016). Conclusions Eagle syndrome is underdiagnosed with potentially serious neurovascular complications, including ischemic stroke. Surgical treatment achieves better outcomes than conservative management. Although traditionally the domain of otorhinolaryngologist, neurologist should include this syndrome in differential diagnostic considerations because of the varied neurological presentations that are amenable to effective treatment.

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Section: Resultsmentioning

confidence: 99%

Neurological phenotypes and treatment outcomes in Eagle syndrome: systematic review and meta-analysis

Hassani,

Grønlund,

Albrechtsen

et al. 2024

PeerJ

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“…Persistent inter-connection between the ES and ICA may lead to repetitive ICA micro-trauma, resulting in the pseudoaneurysm formation with internal thrombus ( 7 , 8 ). Furthermore, the jugular vein can also be compressed by abnormal elongation of the styloid process and the lateral mass of the first cervical vertebral body (C1), leading to increased jugular pressure, insomnia, tinnitus, head noises, headache, earache, and other discomfort.…”

Section: Discussionmentioning

confidence: 99%

Eagle Syndrome with Internal Carotid Artery Compression Causing Recurred Syncope

et al. 2023

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We herein report a 54-year-old man with eagle syndrome who presented with repeated episodes of syncope, especially after moving his head to a downward position. Computed tomography with contrast revealed a bilateral elongated styloid process. The left internal carotid artery was obviously compressed by the left elongated styloid processes. A transcranial Doppler examination detected a significantly decreased blood flow velocity in the left middle cerebral artery when the patient slightly lowered his head position. After surgery, the positional cerebral blood flow alteration disappeared. No further similar syncope episodes have been reported to date.

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“…A comprehensive search of the literature was performed using the PubMed, Embase, Cochran Library and Web of Science databases to retrieve studies published before December 2021 ( ). In the 16 cases reviewed by us, the etiology of 5 cases (31%) was trauma[ 14 - 18 ] and 4 cases (25%) had iatrogenic injury[ 19 - 22 ], while only 2 cases (13%) were spontaneous; however, both spontaneous cases had a history of hypertension and hyperlipidemia[ 23 , 24 ] (Table 1 ). Our patient was a young adult with no personal or family history of cardiovascular disease.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous internal carotid artery pseudoaneurysm complicated with ischemic stroke in a young man: A case report and review of literature

Zhong¹,

Feng²,

Luo³

et al. 2022

WJCC

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BACKGROUND Carotid artery pseudoaneurysm (PSA) is infrequently encountered in clinical settings. Internal carotid artery (ICA) PSA complicated with ischemic stroke is rare. PSAs are typically caused by iatrogenic injury, trauma, or infection. The underlying mechanisms of spontaneous PSA formation are not well characterized. We report a healthy young man who presented with stroke as a complication of spontaneous PSA of the left ICA. CASE SUMMARY A 30-year-old man working as a ceiling decoration worker was hospitalized due to sudden-onset speech disorder and right lower extremity weakness. Medical history was unremarkable. Brain computed tomography revealed ischemic stroke. Digital subtraction angiography showed a left ICA PSA with mild stenosis. The patient was conservatively managed with oral anticoagulation and antiplatelet therapy. He recovered well and was discharged. The patient was in good condition during follow-up. CONCLUSION The occupational history of patient should be taken into consideration while evaluating the etiology of spontaneous ICA PSA in young people with stroke.

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Giant pseudoaneurysm of the external carotid artery causing stroke: A case report

Cited by 8 publications

References 11 publications

Neurological phenotypes and treatment outcomes in Eagle syndrome: systematic review and meta-analysis

Neurological phenotypes and treatment outcomes in Eagle syndrome: systematic review and meta-analysis

Eagle Syndrome with Internal Carotid Artery Compression Causing Recurred Syncope

Spontaneous internal carotid artery pseudoaneurysm complicated with ischemic stroke in a young man: A case report and review of literature

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