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Vol 29, No 3 (2023)
Case report
Published online: 2023-09-01

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Internal carotid artery dissection due to direct mechanical damage caused by the ipsilateral elongated styloid process. A 4-year follow-up

Justyna Putek1, Jędrzej Fischer1, Justyna Korbecka2, Aleksander Truszyński1, Andrzej Szuba1
DOI: 10.5603/aa.94739
Acta Angiologica 2023;29(3):98-102.

Abstract

Internal carotid artery dissection (ICAD) is a complex clinical problem with a multi-causal etiology, in which the intima of the artery ruptures and is detached by the inflowing blood. Causes include trauma, intense exercise, vomiting, prolonged retroflexion of the neck, and spontaneous dissection. The therapy for this condition consists of treatment with anticoagulants or through endovascular intervention in recurrent cases. The aim of this paper is to present a case of ICAD in a young woman complicated by an ischemic stroke caused by an elongated styloid process. This abnormality was found in 3D computed tomography. In the described case, it was decided to start pharmacotherapy and withdraw from the endovascular treatment due to the technical difficulties of the procedure. The patient had been followed up regularly up to 4 years after the incident.

An elongated styloid process may be the cause of Eagle’s Syndrome classified into two types: classical type, and the rare carotid artery type, a component of which is ICAD. It is estimated that the styloid process in this form occurs in 4% of the population, which may indicate that the amount of ICAD caused by this variant of the styloid process is underestimated and should be included in the differential diagnosis of ischemic stroke in young people.

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