Nakayama Taira, Abe Takato, Kashio Nobuko, Ohno Shunya, Togashi Jun, Ohnuki Yoichi, Nagata Eiichiro
Department of Neurology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Tokai J Exp Clin Med. 2025 Jul 20;50(2):48-50.
Elongated styloid processes that interact with the internal carotid arteries (ICAs) have been documented to lead to carotid artery stenosis, occlusion, or dissection, resulting in transient ischemic attack (TIA) or cerebral infarction. This study reports a unique case of bilateral ICA vasospasms triggered by elongated styloid processes and neck movements during physical activity, highlighting a potential vasospastic origin. A 52-year-old man experienced TIAs with visual disturbances while playing golf. Diagnostic imaging, including magnetic resonance angiography (MRA) and dynamic cerebral angiography, was performed to evaluate carotid artery involvement. MRA was used to assess ICA stenosis, while dynamic cerebral angiography was conducted to observe changes in the ICA during neck rotation. Imaging revealed bilateral ICA stenosis and an elongated styloid process. The resolution of the ICA stenosis on follow-up MRA suggested a potential vasospastic origin. Dynamic assessment using cerebral angiography showed narrowing of the right ICA during neck rotation. The vasospasm was likely induced by neck movement during golf.
已证实，与颈内动脉（ICA）相互作用的茎突过长会导致颈动脉狭窄、闭塞或夹层，进而引发短暂性脑缺血发作（TIA）或脑梗死。本研究报告了一例独特的病例，在体育活动期间，过长的茎突和颈部运动引发了双侧ICA血管痉挛，突出了潜在的血管痉挛起源。一名52岁男性在打高尔夫球时出现伴有视觉障碍的TIA。进行了包括磁共振血管造影（MRA）和动态脑血管造影在内的诊断性成像，以评估颈动脉受累情况。MRA用于评估ICA狭窄，而动态脑血管造影则用于观察颈部旋转期间ICA的变化。成像显示双侧ICA狭窄和茎突过长。随访MRA显示ICA狭窄消退，提示潜在的血管痉挛起源。使用脑血管造影进行的动态评估显示，颈部旋转期间右侧ICA变窄。血管痉挛可能是由打高尔夫球期间的颈部运动诱发的。
