Dimopoulos Christos, Bisdas Sotirios, Bisdas Theodosios
Department of Vascular Surgery, Athens Medical Center, Distomou 5-7, 151 25, Marousi, Athens, Greece.
Department of Neuroradiology, Athens Medical Center, Athens, Greece.
J Med Case Rep. 2025 Jul 1;19(1):300. doi: 10.1186/s13256-025-05349-1.
Transient perivascular inflammation of the carotid artery syndrome is a rare and under-recognized clinical condition. It may mimic more serious vascular disorders such as carotid dissection or vasculitis, leading to unnecessary investigations or treatment. Recognition of this benign, self-limiting entity is essential to ensure appropriate management.
We describe the case of a 52-year-old Caucasian Greek woman who presented with acute, well-localized pain on the left side of her neck, centered over the carotid artery and radiating toward the ipsilateral jaw. She had no systemic or neurological symptoms. Physical examination revealed focal tenderness over the left carotid bifurcation. Initial Doppler ultrasound raised suspicion of carotid artery dissection; however, magnetic resonance imaging demonstrated eccentric wall thickening and perivascular fat stranding without luminal narrowing or enhancement, findings consistent with transient perivascular inflammation of the carotid artery syndrome. The differential diagnosis included dissection, vasculitis, and lymphadenopathy, all excluded by clinical and imaging evaluation. The patient was managed conservatively with nonsteroidal antiinflammatory drugs, resulting in complete resolution of symptoms within 4 weeks. Follow-up magnetic resonance imaging at 6 months confirmed no recurrence.
This case highlights the importance of considering transient perivascular inflammation of the carotid artery syndrome in patients presenting with localized neck pain and suggestive imaging features. Accurate diagnosis can help avoid unnecessary interventions and promote effective, conservative treatment.
颈动脉综合征的短暂性血管周围炎症是一种罕见且未得到充分认识的临床病症。它可能会模仿更严重的血管疾病,如颈动脉夹层或血管炎,从而导致不必要的检查或治疗。认识到这种良性、自限性疾病对于确保恰当的管理至关重要。
我们描述了一名52岁的希腊白人女性患者的病例,她出现了左侧颈部急性、定位明确的疼痛,疼痛以颈动脉为中心,并向同侧颌部放射。她没有全身或神经系统症状。体格检查发现左侧颈动脉分叉处有局部压痛。最初的多普勒超声检查怀疑有颈动脉夹层;然而,磁共振成像显示有偏心性壁增厚和血管周围脂肪条索状改变,但管腔无狭窄或强化,这些表现符合颈动脉综合征的短暂性血管周围炎症。鉴别诊断包括夹层、血管炎和淋巴结病,通过临床和影像学评估均排除了这些疾病。患者采用非甾体类抗炎药进行保守治疗,症状在4周内完全缓解。6个月时的随访磁共振成像证实没有复发。
该病例强调了对于出现局部颈部疼痛并有提示性影像学特征的患者,考虑颈动脉综合征的短暂性血管周围炎症的重要性。准确的诊断有助于避免不必要的干预,并促进有效的保守治疗。