Ultrasound Evaluation of Transient Ischemic Attack Caused by Styloid Process Elongation: A Case Report


In 1937, Eagle first described the association of cervicofacial pain and other symptoms with an elongated styloid process (1). The syndrome named after him was divided into two types: classic stylocarotid syndrome and stylocarotid artery syndrome (SAS) (2, 3). SAS is essentially a vascular type of Eagle syndrome, which results in neurological symptoms, including transient ischemic attack (TIA) and stroke, due to internal carotid artery (ICA) compression or dissection caused by an elongated styloid process. Three-dimensional (3D) computed tomography angiography (3D-CTA) is the primary imaging modality used to evaluate SAS owing to its ability to clearly depict an elongated styloid process and its adjacent blood vessels (4).

As a non-invasive imaging method, color Doppler flow imaging (CDFI) can depict the bone structure of the neck but also has the advantage of imaging the carotid artery as well as hemodynamics. However, to the best of our knowledge, there are no reports in the literature describing the detection of SAS using CDFI. In this report, we describe a case involving a 56-year-old man with a history of TIA resulting from compression of the right ICA by an elongated styloid process, and explore the important role of CDFI combined with transcranial Doppler (TCD) in the diagnosis of SAS.