Tanaka Yukiko, Anami Hidenori, Kurihara Hiroyuki, Miyao Satoru, Nakamoto Hidetoshi, Kubota Yuichi, Kawamata Takakazu
Department of Neurosurgery and Stroke Center, TMG Asaka Medical Center, Saitama, Japan; and.
Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
J Neurosurg Case Lessons. 2021 Jun 28;1(26):CASE21286. doi: 10.3171/CASE21286.
Eagle syndrome, or elongated styloid process syndrome, is a rare cause of cerebral infarction. When the styloid process is elongated but the internal carotid artery (ICA) is morphologically normal on three-dimensional computed tomography angiography (3D-CTA), determining the causal relationship between elongation and cerebral infarction is difficult.
The patient was a 27-year-old man who experienced two left cerebral infarctions in 3 months. On 3D-CTA, the styloid process was elongated, but the structure of the ICA was normal. When the patient's neck was rotated leftward, the peak systolic velocity and pulsatility index increased (shown via dynamic subtraction ultrasonography) and ICA stenosis was evident (shown via subtraction angiography). The styloid process was removed, and the cerebral infarction did not recur in the 2 years after surgery.
This is the first report to document that indirect compression of ICA by the styloid process can cause Eagle syndrome. The blood flow changes of the ICA on dynamic ultrasonography revealed morphological changes that were hidden on 3D-CTA or nondynamic subtraction angiography.
鹰综合征，即茎突过长综合征，是脑梗死的一种罕见病因。当茎突过长而三维计算机断层血管造影（3D-CTA）显示颈内动脉（ICA）形态正常时，很难确定茎突过长与脑梗死之间的因果关系。
该患者为一名27岁男性，在3个月内发生了两次左侧脑梗死。3D-CTA显示茎突过长，但ICA结构正常。当患者颈部向左旋转时，收缩期峰值流速和搏动指数增加（动态减影超声显示），且ICA狭窄明显（减影血管造影显示）。切除茎突后，术后2年脑梗死未复发。
这是第一份记录茎突对ICA间接压迫可导致鹰综合征的报告。动态超声检查时ICA的血流变化揭示了3D-CTA或非动态减影血管造影中隐藏的形态学变化。
