Ischemic stroke due to internal carotid artery dissection associated with an elongated styloid process (Eagle syndrome)

Hébant, Benjamin; Guégan-Massardier, Évelyne; Macaigne, Valérie; Triquenot-Bagan, Aude

doi:10.1016/j.jns.2016.10.055

Cited by 23 publications

(28 citation statements)

References 8 publications

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“…6 Head and neck CT scan is the gold standard by visualizing the entire stylohyoid chain and measuring the length of the styloid process Eagle syndrome is confirmed by a styloid process superior to 3 cm. 2,6,9,10 This elongated styloid process can exceptionally cause mechanical conflict with the internal carotid artery, thus defining the stylocarotid syndrome. 6,7,10 This conflict can lead either to direct arterial compression (corresponding to a hemodynamic mechanism), or to carotid dissection or thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Eagle syndrome as a rare cause of recurrent transient ischemic stroke in Senegal (West Africa)

Loum

Lame

Ndiaye

et al. 2021

Int J Otorhinolaryngol Head Neck Surg

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<p>Eagle syndrome is a rare condition, often characterized by nonspecific symptoms. It is due to an abnormally long or compressive styloid process on surrounding structures. Exceptionally, it can cause neuro-vascular manifestations. We report an observation of Eagle syndrome discovered incidentally in presence of recurrent transient ischemic stroke. A 74-year-old man with no cardiovascular risk factors, was admitted to our department following 4 episodes of transient ischemic stroke with right hemiplegia and aphasia, always rapidly resolving. Head and neck CT scan showed 2 long styloid processes with a marked impingement of the left one against the ipsilateral internal carotid artery. Intraoral styloidectomy was performed. The patient recovered fully and remained free of symptoms without neurological impairment, at 6 months. Eagle syndrome is a rare condition which may lead, exceptionally, to repetitive transient ischemic stroke. Surgical styloidectomy must be considered to reduce the risk of new vascular events and prevent serious complications such as dissection of the internal carotid artery.</p>

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Section: Discussionmentioning

confidence: 99%

Eagle syndrome as a rare cause of recurrent transient ischemic stroke in Senegal (West Africa)

Loum

Lame

Ndiaye

et al. 2021

Int J Otorhinolaryngol Head Neck Surg

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“…From the literature review, eight patients underwent solely medical therapy initially,8 9 16 21–25 with three patients requiring surgical or endovascular interventions 8 9 26…”

Section: Discussionmentioning

confidence: 99%

Eagle’s syndrome: a piercing matter

Zammit¹,

Chircop

Attard

et al. 2018

BMJ Case Rep

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We present an unusual case of Eagle’s syndrome with bilateral internal carotid artery dissection in a 45-year-old man. Initial symptomatology included ipsilateral headaches and facial sensory symptoms. A right horner’s syndrome was present on clinical examination. Radiological imaging revealed an old infarct, with bilateral carotid dissections and bilateral elongated styloid processes consistent with Eagle’s syndrome. Despite initiation of secondary prevention with antiplatelet therapy, he had two further ischaemic events. The case highlights the symptomatology and complications of Eagle’s syndrome, with its management discussed through a review of similar case reports.

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“…Other reported cases include descriptions of complications such as ICA dissection, external carotid artery pseudoaneurysm, and carotid stent fracture. 2,14,15 Most of the reported cases present with anterior cerebral (ICA distribution) symptoms due to the limited flow in the anterior cerebrovasculature. 6,[10][11][12][13][15][16][17] This makes our case even more unusual due to the variation in cerebrovascular anatomy (fetal origin of the left posterior cerebral artery) and close proximity of ipsilateral ICA and styloid process.…”

Section: Discussionmentioning

confidence: 99%

“…It is estimated that only 4% of the population has an elongated stylohyoid process, and symptomatic patients represent an even smaller percentage. 2,9 Although uncommon, Eagle syndrome should not be overlooked as a potential diagnosis for positional syncope. The possibility of compression of the extracranial carotid arteries by an elongated styloid process or calcified stylohyoid ligament should be considered and evaluated.…”

Section: Discussionmentioning

confidence: 99%

“…An elongated styloid process is due to calcification of the stylohyoid ligament and is defined as greater than 30 mm in length (Figure 1). [1][2][3][4] Eagle syndrome is estimated to affect 4% to 28% of the population and may have autosomal dominant inheritance but has also been reported to be due to chronic irritation, surgical injury and endocrine changes. 4,5 Eagle syndrome was first described by Watt W. Eagle in 1937 when he reported a variety of symptoms which were associated with an elongated styloid process.…”

Section: Introductionmentioning

confidence: 99%

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Transcranial Doppler for Eagle Syndrome: Rare Presentation of Unilateral Internal Carotid Artery Compression by the Stylohyoid Ligament With Provocative Maneuvers

Skjonsberg

McLemore

Sweet

et al. 2018

Journal for Vascular Ultrasound

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Eagle syndrome is a rare condition caused by compression of the internal carotid artery (ICA) or cranial nerves by an elongated styloid process or calcified stylohyoid ligament. This patient is a 56 year-old woman who presented with episodes of positional syncope for 8 years. Transcranial Doppler (TCD) demonstrated abnormally decreased flow in the left middle cerebral artery (MCA) during the syncopal episodes. The patient was evaluated by TCD, transcranial imaging (TCI), and carotid duplex (CD). First, a baseline CD and TCI were performed with the patient in a neutral position. TCD was then used during symptomatic provocative maneuvers to monitor the bilateral MCAs. Intraoperative TCD monitoring was also done during bilateral stylohyoid ligament resection, and postoperatively during the same provocative maneuvers.The baseline CD examination revealed normal extracranial carotid anatomy; TCD and TCI showed normal mean velocities and a normal anatomic variant of fetal origin of the left posterior cerebral artery. During provocative maneuvers, TCD showed abnormally dampened to absent flow in the left MCA, consistent with compression of the left extracranial ICA. CT scan confirmed elongated stylohyoid ligaments bilaterally. The MCA mean velocities were monitored intraoperatively and postoperatively by TCD and showed no changes with head positioning immediately following resection of the stylohyoid ligaments. The patient reported no syncopal episodes at follow-up 6 days after surgery. Although rare, Eagle syndrome should be considered as a cause of positional syncope. TCD can serve as a diagnostic test, an intraoperative monitoring tool, and a method for documenting the surgical outcome.

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Ischemic stroke due to internal carotid artery dissection associated with an elongated styloid process (Eagle syndrome)

Cited by 23 publications

References 8 publications

Eagle syndrome as a rare cause of recurrent transient ischemic stroke in Senegal (West Africa)

Eagle syndrome as a rare cause of recurrent transient ischemic stroke in Senegal (West Africa)

Eagle’s syndrome: a piercing matter

Transcranial Doppler for Eagle Syndrome: Rare Presentation of Unilateral Internal Carotid Artery Compression by the Stylohyoid Ligament With Provocative Maneuvers

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