scholarly journals P.092 Eagles and Talons: A case of cervical artery dissection from Eagle syndrome and fibromuscular dysplasia

2018 ◽  
Vol 45 (s2) ◽  
pp. S40-S40
Author(s):  
S Wasyliw ◽  
G Hunter
Keyword(s):  
Fibromuscular Dysplasia ◽  
Carotid Bifurcation ◽  
Styloid Process ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Elongated Styloid Process ◽  
Cervical Artery ◽  
Eagle Syndrome ◽  
Computer Tomography Angiography ◽  
The Right

Background: Eagle syndrome (also known as stylohyoid syndrome) and fibromuscular dysplasia (FMD) are rare conditions that have both been shown to be associated with cervical artery dissections (CAD). Direct mechanical injury from a neighboring bony fragement can produce arterial dissections and is the proposed mechanism in Eagle syndrome. The etiology of FMD remains unclear, however, similar shearing stresses have been proposed. We present a case in which both of these conditions were present. Methods: Case report Results: A previously healthy 52 year old male presented with an acute left MCA syndrome with computer tomography angiography followed by convensional angiography confirming a complete occlusion of the left ICA at the carotid bifurcation with evidence of a dissection of the proximal cervical carotid artery. Luminal irregularities proximal to the dissection and also of the right ICA were in keeping with fibromuscular dysplasia. A carotid stent was placed and a thrombectomy was performed for a proximal left M2 occlusion. On further review of the CT, the patient had markedly elongated styloid processes bilaterally, meeting criteria for Eagle syndrome. Conclusions: Previous literature has not described these two conditions coexisiting. We question whether chronic mechanical stress from an elongated styloid process could lead to arteries having an irregular or beading appearance resembling fibromuscular dysplasia.

scholarly journals Cervical artery dissection—an easily neglected cause of stroke: a case report

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ya -Hui Lian ◽  
Xin Chen ◽  
De- Rui Kong ◽  
Wei Chen ◽  
Ming-Chao Shi ◽  
...  
Keyword(s):  
Young People ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Vascular Occlusion ◽  
Artery Dissection ◽  
High Signal ◽  
Cervical Artery Dissection ◽  
Cervical Artery ◽  
The Right

Abstract Background In recent years, the incidence of stroke has gradually increased in young people. There are many reasons causing stroke, including atherosclerosis, artery embolization, and cervical artery dissection and so on. However, cervical artery dissection is a major cause of stroke in young people. We present a case of ischemic stroke caused by dissection, whose distal vascular occlusion due to detachment of the thrombosis in the right internal carotid artery. Case presentation A 33-year-old male patient was admitted to the hospital because of stroke. Imaging examination showed that there was no visualization of the right middle cerebral artery and there were a large number of mural thrombus in the C1 segment of the right internal carotid artery. After emergency surgery, the patient had vascular recanalization and the symptoms were significantly improved. Magnetic resonance imaging showed a high signal in the C1 segment of the right internal carotid artery, the abnormal signal disappeared after antiplatelet therapy. Conclusions When a patient has symptoms of stroke, we need to explore the root cause of stroke. Especially in young people, cervical artery dissection is an important reason that can’t be ignored. Through review and analysis of this case, we hope to improve the understanding of radiologists and clinicians about the cervical artery dissection, reduce the rate of misdiagnosis, and improve patients’ prognosis.

Fibromuscular Dysplasia May Herald Symptomatic Recurrence of Cervical Artery Dissection

2007 ◽  
Vol 23 (5-6) ◽  
pp. 448-452 ◽  
Author(s):  
J.M. de Bray ◽  
G. Marc ◽  
V. Pautot ◽  
B. Vielle ◽  
A. Pasco ◽  
...  
Keyword(s):  
Fibromuscular Dysplasia ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Symptomatic Recurrence ◽  
Cervical Artery

Abstract 49: Male Sex is Associated With Cervical Artery Dissection in Patients With Fibromuscular Dysplasia

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Charlotte Arnaud ◽  
Marion Boulanger ◽  
Aurélien Lorthioir ◽  
Laurence Amar ◽  
Arshid Azarine ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fibromuscular Dysplasia ◽  
Pooled Analysis ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
University Hospitals ◽  
The Us ◽  
Cervical Artery ◽  
History Of ◽  
Male Sex

Background: Cervical artery dissection (CeAD) is one of the most frequent manifestations of fibromuscular dysplasia (FMD). However, the risk factors for CeAD are unknown. We investigated factors associated with CeAD in the ARCADIA (Assessment of Renal and Cervical Artery Dysplasia) registry and performed a pooled analysis of published and unpublished data. Methods: Patients included were women and men ≥18 years, diagnosed with renal, cervical, or intracranial artery FMD, prospectively recruited at 16 university hospitals in France and Belgium. Diagnosis of CeAD was established by stroke specialists in each participating center, according to standard diagnostic criteria. Associations between CeAD and potential determinants were assessed by calculations of crude and adjusted odds ratios. Results: Among 469 patients (415 women) with FMD, 68 (14.5%) had CeAD. CeAD patients were younger, more likely to be men and to have a history of migraine, and less likely to have a history of hypertension, than non-CeAD patients. In the multivariate analysis, male sex (OR=2.75 ; CI95% 1.39-5.46), history of migraine (OR=1.93 ; 1.08-3.44), age >50 years (OR=0.41 ; 0.23-0.74), history of hypertension (OR=0.35 ; 0.19-0.63), and the number of vascular beds involved by FMD >=3 (OR=2.46 ; 1.13-5.35) remained significantly associated with CeAD. We collected data from 2 published studies and unpublished data from the US and the European Registries. There was no overlap between studies. In a pooled analysis (289 CeAD in 1933 patients), male sex was significantly associated with CeAD (pooled OR=2.04 ; 1.41-2.95, I2=0%, Figure). Conclusion: In patients with FMD, male sex and multisite involvement are associated with of CeAD, in addition to other previous known risk factors.

CLINICAL CHARACTERISTICS OF PATIENTS WITH SPONTANEOUS CERVICAL ARTERY DISSECTION - THE POLISH REGISTRY FOR FIBROMUSCULAR DYSPLASIA (ARCADIA-POL STUDY)

2018 ◽  
Vol 36 (Supplement 1) ◽  
pp. e126
Author(s):  
P. Talarowska ◽  
E. Warchol-Celinska ◽  
I. Kurkowska-Jastrzebska ◽  
A. Kostera-Pruszczyk ◽  
D. Gasecki ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Fibromuscular Dysplasia ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Cervical Artery

scholarly journals Clinical Features of Patients With Cervical Artery Dissection and Fibromuscular Dysplasia

Stroke ◽  
2021 ◽  
Author(s):  
Sonia Bonacina ◽  
Mario Grassi ◽  
Marialuisa Zedde ◽  
Andrea Zini ◽  
Anna Bersano ◽  
...  
Keyword(s):  
Risk Factor ◽  
Odds Ratio ◽  
Clinical Characteristics ◽  
Fibromuscular Dysplasia ◽  
Vascular Pathology ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Risk Factor Profile ◽  
Cervical Artery ◽  
History Of

Background and Purpose: Observational studies have suggested a link between fibromuscular dysplasia and spontaneous cervical artery dissection (sCeAD). However, whether patients with coexistence of the two conditions have distinctive clinical characteristics has not been extensively investigated. Methods: In a cohort of consecutive patients with first-ever sCeAD, enrolled in the setting of the multicenter IPSYS CeAD study (Italian Project on Stroke in Young Adults Cervical Artery Dissection) between January 2000 and June 2019, we compared demographic and clinical characteristics, risk factor profile, vascular pathology, and midterm outcome of patients with coexistent cerebrovascular fibromuscular dysplasia (cFMD; cFMD+) with those of patients without cFMD (cFMD–). Results: A total of 1283 sCeAD patients (mean age, 47.8±11.4 years; women, 545 [42.5%]) qualified for the analysis, of whom 103 (8.0%) were diagnosed with cFMD+. In multivariable analysis, history of migraine (odds ratio, 1.78 [95% CI, 1.13–2.79]), the presence of intracranial aneurysms (odds ratio, 8.71 [95% CI, 4.06–18.68]), and the occurrence of minor traumas before the event (odds ratio, 0.48 [95% CI, 0.26–0.89]) were associated with cFMD. After a median follow-up of 34.0 months (25th to 75th percentile, 60.0), 39 (3.3%) patients had recurrent sCeAD events. cFMD+ and history of migraine predicted independently the risk of recurrent sCeAD (hazard ratio, 3.40 [95% CI, 1.58–7.31] and 2.07 [95% CI, 1.06–4.03], respectively) in multivariable Cox proportional hazards analysis. Conclusions: Risk factor profile of sCeAD patients with cFMD differs from that of patients without cFMD. cFMD and migraine are independent predictors of midterm risk of sCeAD recurrence.

scholarly journals Eaglov sindrom

2017 ◽  
Vol 86 ◽  
Author(s):  
Mladen Gasparini ◽  
Primož Praček ◽  
Jani Muha ◽  
Uroš Tomić
Keyword(s):  
Average Length ◽  
Cranial Nerves ◽  
Styloid Process ◽  
Computed Tomographic Angiography ◽  
Measurement Tool ◽  
Computed Tomographic ◽  
Elongated Styloid Process ◽  
Eagle Syndrome ◽  
The Right ◽  
Tomographic Angiography

Background: In the present article we present the characteristics of Eagle syndrome, which is an often overlooked cause of chronic pain in the neck and head. The syndrome is caused by the compression of an elongated styloid process on the adjacent cranial nerves or the carotid arteries. Since there are disparate data in the literature regarding the proportion of people with an elongated styloid process, we conducted a survey to determine the percentage of patients with an elongated styloid process in a group of subjects who underwent computed tomographic imaging of the neck vessels in our institution.Methods: We analyzed the images of 104 patients who were referred to our institution for computed tomographic angiography of the neck between the years 2014 and 2016. With the help of a software measurement tool, we determined the length of the styloid processes and compared the length of the processes on both sides and in both genders. Patients with an elongated styloid process were reviewed for any symptoms of Eagle syndrome.Results: The average age of the reviewed patients was 67.1 years. Both genders were equally represented (51 % men and 49 % women). The average length of the styloid process was 23.8 (7.0) mm, with 23 patients (22.1 %) having a styloid process longer than 30 mm. In one third of those patients the styloid process was elongated bilaterally. There were no differences in the average length of the styloid process between men and women and between the left and the right side. Among patients with an elongated styloid process, only one (4.3 %) had symptoms attributable to the Eagle syndrome.Conclusions: Eagle syndrome should be suspected in a patient with repetitive, dull pain in the throat and neck, which worsens during speaking, chewing or swallowing. The diagnosis is confirmed by computed tomography which could demonstrate an elongated styloid process and exclude other causes for neck pain. With regard to the results of our study, an elongated styloid process is found in a relatively high percentage of patients but the condition is only rarely symptomatic.

scholarly journals Elongated Styloid Process: Mapping the incidence in Greek population

2021 ◽  
Vol 9 (2.2) ◽  
pp. 7994-8000
Author(s):  
Vasilopoulos Anastasios ◽  
◽  
Tsoucalas Gregory ◽  
Thomaidis Vasileios ◽  
◽  
...  
Keyword(s):  
Head And Neck ◽  
Steel Wire ◽  
Styloid Process ◽  
Greek Population ◽  
Elongated Styloid Process ◽  
Stylomastoid Foramen ◽  
Close Proximity ◽  
Eagle Syndrome ◽  
Different Populations ◽  
The Right

Background: Styloid process (SP) is a needle shaped projection of the temporal bone, which lies in close proximity to several important anatomical structures of the head and neck. It attracts the attention of anatomists, otolaryngologists and head and neck surgeons, as an abnormally long SP is linked with a clinical condition known as Eagle Syndrome. There are numerous studies in the literature investigating morphometric characteristics of SP, including its length in different populations. The aim of this study is to investigate the incidence of SP elongation in Greek population and to construct an epidemiologic map showing the incidence of SP elongation across different regions of Greek territory. Materials and methods: Two hundred and nine skulls retrieved from cemeteries across Greece were meticulously examined. Ninety-four male skulls and one-hundred and fifteen females, all of Hellenic origin. SP length was measured from the lowest inner point of the surface between the SP and the stylomastoid foramen to its tip, utilizing a digital caliper and a steel wire. Data from this study were statistically analyzed and combined with data from other studies in Greek population in order to construct a detailed epidemiologic map. Results: The mean length was 27.26 ± 5.89 mm for the left and 27.84 ± 6.31 mm for the right SP. In males 36.4% of the left and 37.8% of the right SP were elongated. In females the incidence of SP elongation was 14.3% and 15.5% for left and right side respectively. Statistically significant association was observed between gender and SP length but not between age and SP length. Conclusion: This study enriches the literature by adding information about elongated SP incidence in Greek population. It reviews the existing studies about SP length in Greeks and presents an epidemiologic map showing the incidence of SP elongation across different regions in Greece. KEY WORDS: Skull, Eagle syndrome, Hellenic population, Elongated Styloid Process.

scholarly journals Styloid process elongation in a sample of Lebanese population: a consideration for the prevention of Eagle syndrome

2020 ◽  
Author(s):  
Georges Aoun ◽  
Nour Srour ◽  
Abbass El-Outa ◽  
Ibrahim Nasseh
Keyword(s):  
Retrospective Study ◽  
Population Sample ◽  
Styloid Process ◽  
Common Finding ◽  
Panoramic Radiographs ◽  
Elongated Styloid Process ◽  
Lebanese Population ◽  
Eagle Syndrome ◽  
The Right

Background. The objective of this study was to investigate the prevalence and patterns of styloid process elongation in a general Lebanese population sample. Methods. Digital panoramic radiographs of 489 Lebanese adults (218 males and 271 females, mean age of 47.56 ± 16.149) were included in this retrospective study. First, we screened for detection of elongated styloid process, then we analyzed these cases and classified the elongation types. Data obtained were transformed into SPSS v24 and descriptive and inferential analyses were done.  Results. In our sample, elongated styloid process was seen in 76 cases (15.5%) (45/271 women and 31/218 men). Despite no significant gender predisposition, females were slightly more affected than males (59.2% females to 40.8% males). As for the age, elongation was significantly more likely to be present at 45-64 years of age. The right side was slightly more affected than the left side (86.8% vs. 76.3% respectively), with type 1 elongation as the most common. Nevertheless, bilateral elongation was much more common than unilateral elongation (63.2%). Interestingly, females were more likely to suffer from bilateral elongation (64.58%) compared to men (35.41%). Conclusion. Elongated styloid process represents a common finding detected fortuitously on panoramic radiographs. Therefore, being a main feature in Eagle syndrome, dentists should be aware of this clinical entity and actively screen for it.

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