A case of cerebral infarction in which a carotid artery stent was fractured by an elongated styloid process(eagle syndrome)

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE
Nobuhiro Yoshimi , Hiromitsu Hatakeyama , Kazuo Matsui , Noriyuki Katsumata , Satoshi Yamada , Kiyoshi Misawa
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Abstract

Eagle’s syndrome is characterized by laryngopharyngeal hypersensitivity, such as sore throat and dysphagia in otorhinolaryngology. It is caused by mechanical pressure from the styloid process that extends to ≥ 25 mm. In most cases, the symptoms appear unilaterally. There are two primary symptoms as follows: (i) classic stylohyoid syndrome, which occurs after tonsillectomy; (ii) stylo-carotid artery syndrome, which involves compression of the carotid artery or sympathetic nerve. We experienced a case of repeated cerebral infarctions due to stylo-carotid artery syndrome. Details of the case are shown below. An elongated styloid process caused three times cerebral infarctions due to internal carotid artery dissection. Internal carotid artery dissection treated with carotid artery stent. But after that, the carotid artery stent was fractured by the styloid process compression. As a result, he suffered a fourth cerebral infarction due to embolization caused by the stent fragments. Using CT angiography and angiography, we diagnosed carotid artery dissection and carotid stent fracture due to an elongated styloid process. In addition to medical therapy for cerebral infarction, we surgically resected the styloid process to prevent recurrence. The scattered stent fragments in the cerebral artery were difficult to remove and were left behind. However, he has not had a recurrence two and a half years. In order to prevent repeated or iatrogenic cerebral infarction, we believe that an elongated styloid process should be resected before stent treatment.
脑梗死颈动脉支架被茎突拉长骨折1例(鹰综合征)
鹰氏综合征的特征是喉部过敏,如耳鼻喉科的喉咙痛和吞咽困难。它是由茎突的机械压力引起的,延伸到≥ 25 mm。在大多数情况下,症状单侧出现。主要有以下两种症状:(i)扁桃体切除术后出现的典型茎突舌骨综合征;(ii)茎突-颈动脉综合征,累及颈动脉或交感神经受压。我们有一例因颈动脉柱状动脉综合征引起的反复脑梗死。案例的细节如下所示。由于颈内动脉剥离,茎突延长导致三次脑梗死。颈动脉支架治疗颈内动脉夹层。但在此之后,颈动脉支架因茎突压迫而断裂。结果,由于支架碎片引起的栓塞,他遭受了第四次脑梗死。通过CT血管造影和血管造影,我们诊断颈动脉夹层和颈动脉支架因茎突拉长而断裂。除了药物治疗脑梗死,我们手术切除茎突,以防止复发。脑动脉内分散的支架碎片难以清除,留下。然而,他已经两年半没有复发了。为了防止复发性或医源性脑梗死,我们认为在支架治疗前应切除细长茎突。
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来源期刊
CiteScore
0.80
自引率
0.00%
发文量
129
审稿时长
83 days
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