Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202500082
Jornal Vascular Brasileiro
Case Report

Bilateral carotid dissection due to Eagle syndrome: case report

Dissecção bilateral de carótida por síndrome de Eagle: relato de caso

Anita dos Santos Cardoso; Yago Marcelino Maciel; Ruymara Candal Nogueira; Rafaela Tezza Matiola; Thais Pereira da Rosa; Fernando Topanotti Tarabay; Gregory Vinícius Périco; Brunella Flores Pupo

http://dx.doi.org/10.1590/1677-5449.202500082 J Vasc Bras, vol.25, e20250008, 2026
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Abstract

Eagle Syndrome (ES), characterized by elongation of the styloid process (ESP), is a rare condition with diverse symptoms. Among its complications, carotid dissection is a significant outcome requiring accurate diagnosis and intervention. This study describes a case of bilateral carotid dissection associated with ES, emphasizing diagnostic challenges, management, and therapeutic approaches. Conducted under Research Ethics Committee protocol 68193123.5.0000.0119 and approval number 6.028.970, it reports on a 38-year-old woman with a 5-day history of left-sided headache, otalgia, syncope, right-hand limitation, and visual blurring. MRI revealed left carotid bulb occlusion and recent ischemic events, while angio-CT confirmed bilateral carotid dissections. After clinical management failed, an intraoral surgical approach was chosen, resulting in full neurological recovery. CT confirmed ESP, and genetic testing was negative. This case highlights the need to consider ES in atypical cervicofacial symptoms, given its underdiagnosed incidence (~4% for ESP; ~0.16% for ES), reinforcing the importance of better clinical guidelines.

Keywords

internal carotid artery dissection; stylo-carotid syndrome; craniofacial abnormalities

Resumo

A Síndrome de Eagle (SE), caracterizada pelo alongamento do processo estiloide (APE), é uma condição rara com sintomas diversos. Entre suas complicações, dissecção carotídea é desfecho relevante que requer diagnóstico e intervenção precisos. Este estudo descreve caso de dissecção carotídea bilateral associada à SE, enfatizando desafios diagnósticos, manejo e abordagens terapêuticas. Realizado sob CAAE 68193123.5.0000.0119, aprovação 6.028.970, relata caso de mulher de 38 anos que apresentava cefaleia intensa à esquerda há 5 dias, otalgia, síncope, limitação da mão direita e turvação visual. Ressonância magnética revelou oclusão do bulbo carotídeo esquerdo e eventos isquêmicos recentes, enquanto angio-TC confirmou dissecções carotídeas bilaterais. Por falha no manejo clínico, optou-se pela abordagem cirúrgica intraoral, com recuperação neurológica completa. TC confirmou APE e teste genético foi negativo. Há necessidade de considerar a SE em sintomas cervicofaciais atípicos, dada a sua incidência subdiagnosticada (~4% para APE; ~0,16% para SE), reforçando a importância de melhores orientações clínicas.

Palavras-chave

 dissecção da artéria carótida interna; síndrome estiloide-carotídea; anormalidades craniofaciais

References

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Submitted date:
02/08/2025

Accepted date:
01/19/2026

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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