![]() ![]() The issue of neck trauma as a contributing factor has been widely discussed, vis-à-vis a variety of changes it might produce, such as completing the ossification of the stylohyoid ligament, the pseudoaneurysm formation, and at last, the dissection itself of the carotid artery. Worth mentioning is the fact that all patients initially reported from Eagle himself had a tonsillectomy before the appearance of the syndrome, with a dense postoperative scar, that logically should have influenced into the calcification of the styloid process during the installation of the symptomatology. Nevertheless, some cases will show recurrencies due to transient ischemic attacks while the extracranial internal portion of the carotid artery is compressed between the styloid process and the vertebral bodies. Minor neck traumas before the episode have been reported mainly when discussing the posterior cerebral circulation, in the so-called “ beauty parlor syndrome” that affects vertebral arteries. It is unclear how and when the elongated, calcified styloid process will affect so seriously the carotid artery as to dissect it, especially as long as the event is acute. The carotid artery might be impinged when the styloid process is elongated and calcified, leading to arterial dissection and following neurological injuries. ![]() The second form, which falls into the scope of neurological specialty and as such has a much more serious clinical picture, is the stylocarotid variant. This is as much as true especially when the syndrome presents in its “classical” form, with sore throat, otalgia, tinnitus, and dysphagia among other. CASE DESCRIPTIONĪs a relatively new diagnostic construction, Eagle syndrome is something easily missed during routine neurological visits furthermore, an important part of the complaints belongs to the specialties dealing with oral problems. We report the case of an Eagle syndrome with bilateral elongation of stylohyoid process that presented with ischemic stroke, in a previously healthy male patient. ![]() The elongation of the styloid process might be an incidental finding, might present with relatively benign symptomatology such as neck swelling or submandibular mass, but in some cases, the carotid artery will be severely affected with subsequent serious neurological events. The pioneering work of de Marchettis has been widely cited, as the first author to note that the styloid process might reach the “horns of the hyoid bone: cornua ossis hyoidei.” Maybe already at that time, the elongation of the styloid process and/or the ossification-calcification of the stylohyoid ligament were suspected as disease-prone conditions, but the systematization of the clinical picture was yet to come.ĭetails of the condition were reported approximately three centuries later, when Eagle in 1937 described the homonymous syndrome. It is not an unknown medical condition, although the first quoted source comes from an anatomist: Dominicus de Marchettis. The styloid process and the stylohyoid ligament, part of the neck structures, may present a variety of anatomical changes whose appearance can be purely innocuous as well as causing severe medical occurrences related to these alterations. Keywords: Brain infarct, Carotid artery, Eagle syndrome, Stylohyoid ligament, Styloid process The patient was hospitalized at a neurological facility and thereafter referred to surgery for styloidectomy.Ĭonclusion: The present case underscores the need for a prompt diagnosis and an enhanced awareness of this syndrome, especially among emergency department professionals. The brain ischemia (left temporal brain infarct) was due to carotid artery dissection, and the left internal carotid artery was not visualized during the contrast-enhanced angiography. Imaging at the emergency department (magnetic resonance of the brain and computerized angiography) showed the presence of elongated styloid process bilaterally with clear predomination at the left side. Background: Eagle syndrome, due to the elongation of the styloid process as well as the calcification of the stylohyoid ligament, rarely presents itself with a major neurological disorder such as a brain infarct.Ĭase Description: Authors describe the case report of a previously healthy 64-year-old Caucasian male that complained of inability to control his right upper and lower extremity of an acute nature. ![]()
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