Abreu Jéssica A, Rocha Cláudia A, Cruz Sofia G, Barreira João S
Internal Medicine, Hospital de Vila Franca de Xira, Vila Franca de Xira, PRT.
Serviço de Saúde da Região Autónoma da Madeira, Centro de Saúde de Machico, Funchal, PRT.
Cureus. 2023 Jul 2;15(7):e41275. doi: 10.7759/cureus.41275. eCollection 2023 Jul.
Transient perivascular inflammation of the carotid artery (TIPIC) is an uncommon condition characterized by inflammation of the carotid artery wall, leading to unilateral neck pain. While TIPIC has been acknowledged by the International Classification of Headache Disorders, only a few patient series have been published thus far. The clinical presentation of TIPIC syndrome typically manifests as unilateral neck pain localized specifically over the carotid artery. This pain is accompanied by ipsilateral tenderness and increased arterial pulsation. The condition commonly follows a self-limited course or demonstrates a favorable response to treatment with nonsteroidal anti-inflammatory drugs. When evaluating patients with suspected TIPIC syndrome, conducting a comprehensive assessment of their clinical history is imperative, while utilizing imaging studies to exclude any potential structural abnormalities of the carotid artery effectively. The authors present a case involving a 57-year-old woman who presented with a two-month history of persistent left cervical pain and tenderness. Ultrasonography findings revealed indirect indications of inflammation in the intima-media layer of the carotid artery, suggestive of carotidynia. Notably, other significant differential diagnoses such as aneurysms or carotid dissection were ruled out. Over the course of the evaluation, there was a gradual and spontaneous improvement in both clinical symptoms and radiological findings, indicating the resolution of the inflammatory process as confirmed by imaging follow-up. This case presents a rare and atypical manifestation of transient neck pain attributed to TIPIC.
颈动脉短暂性血管周围炎症(TIPIC)是一种罕见病症,其特征为颈动脉壁炎症,可导致单侧颈部疼痛。虽然TIPIC已被《国际头痛疾病分类》认可,但迄今为止仅发表了少数患者系列报道。TIPIC综合征的临床表现通常表现为单侧颈部疼痛,具体定位在颈动脉上方。这种疼痛伴有同侧压痛和动脉搏动增强。该病症通常呈自限性病程,或对非甾体类抗炎药治疗有良好反应。在评估疑似TIPIC综合征的患者时,必须全面评估其临床病史,同时利用影像学检查有效排除颈动脉的任何潜在结构异常。作者报告了一例病例,患者为一名57岁女性,有持续两个月的左侧颈部疼痛和压痛病史。超声检查结果显示颈动脉内膜中层有炎症的间接迹象,提示为颈动脉痛。值得注意的是,排除了其他重要的鉴别诊断,如动脉瘤或颈动脉夹层。在评估过程中,临床症状和影像学表现均逐渐自发改善,影像学随访证实炎症过程已消退。该病例呈现了TIPIC所致短暂性颈部疼痛的罕见非典型表现。