Eagle syndrome as a cause of transient ischemic attacks

• Published in: Journal of neurosurgery Vol. 110; no. 1; p. 90
• Main Authors: Farhat, Hamad I, Elhammady, Mohamed Samy, Ziayee, Habib, Aziz-Sultan, Mohammad Ali, Heros, Roberto C
• Format: Journal Article
• Language: English
• Published: United States 01.01.2009
• Subjects: Aged; Carotid Artery, Internal - diagnostic imaging; Carotid Artery, Internal - surgery; Cerebral Angiography; Cranial Nerve Diseases - complications; Humans; Ischemic Attack, Transient - etiology; Male; Nerve Compression Syndromes - complications; Neurosurgical Procedures; Postoperative Care; Tomography, X-Ray Computed; Treatment Outcome
• ISSN: 0022-3085
• DOI: 10.3171/2008.3.17435

Eagle syndrome is an uncommon entity but is well known in the otorhinolaryngology and oral surgery literature. This syndrome results from the compression of cranial nerves in the neck by an elongated styloid process causing unilateral cervical and facial pain. The styloid process can also cause compression of the cervical carotid arteries leading to the so-called carotid artery syndrome together with carotidynia or neurological symptoms due to flow reduction in these arteries. The authors discuss the case of a 70-year-old man who suffered from transient ischemic attacks on turning his head to the left, with immediate remission of symptoms when his head returned to the neutral position. The patient was studied with dynamic angiography, which clearly showed focal flow restriction. Once a diagnosis was made, the styloid process was removed surgically and the patient completely recovered from his symptoms. A postoperative angiogram demonstrated complete resolution of the pathology. Neurosurgeons might encounter patients with Eagle syndrome and should be aware of the symptoms and signs. Once the diagnosis is made, the treatment is clear and very effective.