This report describes the presentation and management of a case of Eagle's syndrome in a 30-year-old male. This disease is a rare cause of unilateral cervicofacial pain due to elongated and calcified styloid process. This patient was managed with trans-oral styloidectomy after an extensive workup involving multiple specialties. One month postsurgery, the patient is doing well and reports resolution of symptoms with no recurrence or complications.

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Article Synopsis
  • Eagle syndrome usually involves a long styloid process stressing the internal carotid artery (ICA), but a case is presented where a patient had ICA dissection without elongation of the styloid process.
  • A 43-year-old man experienced left hemiparesis and underwent treatment for a blockage in the right middle cerebral artery and ICA, where the styloid process was found to be linked to the dissection.
  • The authors suggest that even a normal-length styloid process can cause mechanical stress that leads to ICA dissection, highlighting the importance of assessing the styloid process in patients with cervical ICA dissection.
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Background: Glossopharyngeal neuralgia (GPN) is a rare condition typically manifesting as paroxysms of sharp, lancinating pain localized to the middle ear and auditory canal, base of the tongue, tonsillar fossa, and region just inferior to the angle of the mandible. Vascular compression is a common etiology, and microvascular decompression (MVD) has been established as a safe and efficacious treatment in adults. With the exception of one report of an adult patient undergoing the procedure for symptomatology that began in adolescence, there are no published cases of MVD for GPN in pediatric patients to the author's knowledge.

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Recurrent Internal Carotid Artery Dissection Due to Missed Diagnosis of Eagle Syndrome.

World Neurosurg

January 2025

Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland.

An unusual case of a patient with bilateral carotid artery dissection caused by compression from elongated styloid processes is presented. The diagnosis was overlooked 8 years earlier. Eagle syndrome, marked by an elongated styloid process, can result in cervical artery dissection, highlighting the significance of recognizing this correlation in recurrent cases, which occur more frequently than idiopathic internal carotid artery dissections.

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