Eagle syndrome as a cause of transient ischemic attacks

Case report

Hamad I. FarhatDepartment of Neurological Surgery, Leonard M. Miller School of Medicine, University of Miami, Florida

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Mohamed Samy ElhammadyDepartment of Neurological Surgery, Leonard M. Miller School of Medicine, University of Miami, Florida

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Habib ZiayeeDepartment of Neurological Surgery, Leonard M. Miller School of Medicine, University of Miami, Florida

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Mohammad Ali Aziz-SultanDepartment of Neurological Surgery, Leonard M. Miller School of Medicine, University of Miami, Florida

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Roberto C. HerosDepartment of Neurological Surgery, Leonard M. Miller School of Medicine, University of Miami, Florida

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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.

Abbreviation used in this paper:

ICA = internal carotid artery.
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  • 1

    Chase DC, , Zarmen A, , Bigelow WC, & McCoy JM: Eagle's syndrome: a comparison of intraoral versus extraoral surgical approaches. Oral Surg Oral Med Oral Pathol 62:625629, 1986

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  • 2

    Eagle WW: Elongated styloid process. Further observations and a new syndrome Arch Otolaryngol 47:630640, 1948

  • 3

    Eagle WW: Elongated styloid process. Report of two cases Arch Otolaryngol 25:584587, 1937

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    Slavin KV: Eagle syndrome: entrapment of the glossopharyngeal nerve? Case report and review of the literature. J Neurosurg 97:216218, 2002

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    Strauss M, , Zohar Y, & Laurian N: Elongated styloid process syndrome: intraoral versus external approach for styloid surgery. Laryngoscope 95:976979, 1985

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