Recurrence of internal carotid artery dissection associated with elongated styloid process: A case report.

Surg Neurol Int

Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Ritto, Shiga, Japan.

Published: September 2021

AI Article Synopsis

  • * A 59-year-old man had a series of TIAs and was diagnosed with idiopathic internal carotid artery (ICA) dissection, which was ultimately linked to his elongated styloid process.
  • * After undergoing surgery to remove the elongated styloid process and placing a cervical stent, the patient experienced no further ischemic attacks, indicating a potential solution for similar cases.

Article Abstract

Background: An elongated styloid process is known to cause ischemic stroke. Previous reports claim that internal carotid artery (ICA) dissection due to the elongated styloid process has good outcomes when treated conservatively; however, long-term follow-up has not been attempted and recurrence in the later period has not been reported so far. We report a case of recurrence of symptoms over a decade after the initial onset.

Case Description: A 59-year-old man experienced a transient ischemic attack (TIA) 10 years ago. Six years ago, he experienced hemispheric TIA, and magnetic resonance angiography revealed a diminished signal of the left ICA; however, no further examination was performed. Four years ago, he experienced another transient amaurosis attack and was treated with antiplatelet therapy because no embolic source was detected using ultrasonography examination, and he was diagnosed with idiopathic ICA dissection. Recently, he experienced a third amaurosis fugax attack. Digital subtraction angiography and cone-beam computed tomography demonstrated left cervical ICA dissection due to elongated styloid process. He underwent surgical resection of the left styloid process and cervical stent placement. He had no ischemic attacks postoperatively.

Conclusion: The elongated styloid process may cause recurrent ischemic attacks over a decade due to ICA dissection.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8492427PMC
http://dx.doi.org/10.25259/SNI_536_2021DOI Listing

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