Eagle syndrome is a rare cause of stroke and results as a complication of the elongated styloid process (ESP), which can cause carotid dissection and consequent ischemic stroke. We report a case of a 42-year-old woman with a past medical history of rheumatoid arthritis who developed left hemispheric ischemic stroke after deep tissue massage. Imaging studies revealed an intimal tear of the left carotid artery bulb and bilaterally ESPs, measuring approximately 6 cm on the right and 4.5 cm on the left. It seems that direct vascular compromise by the anomalous styloid process was the cause of her carotid artery dissection and stroke. Moreover, neck manipulation may have been a contributing factor.
EagleWW. Elongated styloid processes: report of two cases. Arch Otolaryngol. 1937;25(5):584–587.
2.
CawichSGardnerMJohnsonPShettyRWolfK. The clinical significance of an elongated styloid process. Internet J Fam Pract. 2008;6(1):3.
3.
SmootTWTahaATarlovNRiebeB. Eagle syndrome: a case report of stylocarotid syndrome with internal carotid artery dissection. Interv Neuroradiol. 2017;23(4):433–436.
4.
HanMKKimDWYangJY. Non surgical treatment of Eagle’s syndrome—a case report. Korean J Pain. 2013;26(2):169–172.
5.
MoonCSLeeBSKwonYD. Eagle’s syndrome: a case report. J Korean Assoc Oral Maxillofac Surg. 2014;40(1):43–47.
6.
PiagkouMAnagnostopoulouSKouladourosKPiagkosG. Eagle’s syndrome: a review of the literature. Clin Anat. 2009;22(5):545–558.
EagleWW. Elongated styloid process: symptoms and treatment. AMA Arch Otolaryngol. 1958;67(2):172–176.
11.
EsiobuPCYooMJKirkhamEMZierlerREStarnesBWSweetMP. The role of vascular laboratory in the management of Eagle syndrome. J Vasc Surg Cases Innov Tech. 2018;4(1):41–44.
12.
JelodarSGhadirianHKetabchiMAhmadi KarvighSAlimohamadiM. Bilateral ischemic stroke due to carotid artery compression by abnormally elongated styloid process at both sides: a case report. J Stroke Cerebrovasc Dis. 2018;27(6):e89–e91.
13.
SubediRDeanRBaronosSDhamoonA. Carotid artery dissection: a rare complication of Eagle syndrome. BMJ Case Rep. 2017;2017:bcr2016218184.
14.
RaserJMMullenMTKasnerSECucchiaraBLMesseSR. Cervical carotid artery dissection is associated with styloid process length. Neurology. 2011;77(23):2061–2066.
15.
EagleWW. Symptomatic elongated styloid process report of two cases of styloid process-carotid artery syndrome with operation. Arch Otolaryngol. 1949;49(5):490–503.
16.
EagleWW. Elongated styloid process: further observations and a new syndrome. Arch Otolaryngol. 1948;47(5):630–640.
17.
OguraTMineharuYTodoKKoharaNSakaiNCarotid artery dissection caused by an elongated styloid process: three case reports and review of the literature. NMC Case Rep J. 2015;2(1):21–25.
18.
AldakkanADunnMWarsiNMMansouriAMarottaTR. Vascular Eagle’s syndrome: two cases illustrating distinct mechanisms of cerebral ischemia. J Radiol Case Rep. 2017;11(8):1–7.
RenardDAzakriSArquizanCSwinnenBLabaugePThijsV. Styloid and hyoid bone proximity is a risk factor for cervical carotid artery dissection. Stroke. 2013;44(9):2475–2479.
21.
RazakAShortJLHussainSI. Carotid artery dissection due to elongated styloid process: a self-stabbing phenomenon. J Neuroimaging. 2014;24(3):298–301.
