Kohara Kotaro, Kawamata Takakazu
Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, JPN.
Cureus. 2023 Aug 22;15(8):e43911. doi: 10.7759/cureus.43911. eCollection 2023 Aug.
Jaw claudication is a common symptom of giant cell arteritis (GCA), although atherothrombotic external carotid artery (ECA) occlusion is also known to cause jaw claudication. The patient was a 75-year-old male who experienced severe right jaw pain while chewing solid food. Magnetic resonance (MR) angiography showed right ECA occlusion. Based on laboratory tests and contrast-enhanced computed tomography (CT) angiography, atherothrombosis, not GCA, was suspected to be the cause of jaw claudication. Following conservative therapy with cilostazol, the pain was gradually alleviated in two months, and subsequent MR angiography after four months showed blood flow in the stenosed right ECA. The symptom completely disappeared in six months. Based on a previous report, we expected that jaw claudication will be ameliorated due to the development of collateral supply; however, spontaneous ECA recanalization caused improvement of symptoms in this case.
颌部间歇性运动障碍是巨细胞动脉炎（GCA）的常见症状，不过已知动脉粥样硬化血栓形成导致的颈外动脉（ECA）闭塞也会引起颌部间歇性运动障碍。该患者为一名75岁男性，在咀嚼固体食物时出现严重的右侧颌部疼痛。磁共振（MR）血管造影显示右侧ECA闭塞。基于实验室检查和增强计算机断层扫描（CT）血管造影，怀疑动脉粥样硬化血栓形成而非GCA是颌部间歇性运动障碍的病因。在用西洛他唑进行保守治疗后，疼痛在两个月内逐渐缓解，四个月后的后续MR血管造影显示右侧狭窄的ECA有血流。症状在六个月时完全消失。根据之前的一份报告，我们预计由于侧支循环的形成，颌部间歇性运动障碍会得到改善；然而，在本例中，ECA的自发再通导致了症状的改善。
