著者

入佐 剛 大田 元 山﨑 浩司 内之倉 俊朗 竹島 秀雄

出版者

一般社団法人 日本脳卒中の外科学会

雑誌

脳卒中の外科 (ISSN:09145508)

巻号頁・発行日

vol.46, no.3, pp.210-215, 2018 (Released:2018-07-06)

参考文献数

14

被引用文献数

1 1

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Eagle's syndrome presents with a series of symptoms caused by an elongated styloid process and/or the ossification of part of the entire stylohyoid ligament. Symptoms of the classic type are caused by factors such as irritation and compression of the lower cranial nerve, sore throat and dysphagia, facial pain, and neck pain. The other rare type is caused by compression or dissection of the carotid artery, causing a transient ischemic attack or stroke. This report describes a case of Eagle's syndrome with cerebral infarction caused by internal carotid artery (ICA) dissection, treated with endovascular revascularization of the ICA and surgical resection of the styloid process. A 51-year-old woman presented with sudden onset of right hemiparesis and aphasia. Magnetic resonance imaging revealed left ICA occlusion. Endovascular recanalization therapy for the ICA occlusion was initiated, and recanalization with thrombolysis of the cerebral infarction (TICI) grade IIb was achieved. Carotid artery dissection with intraluminal thrombus was observed at the extracranial portion. Computed tomographic angiography on day 6 revealed the dissected ICA compressed by the elongated styloid process. On day 24, the elongated styloid process was resected extraorally, and successful decompression of the ICA was achieved. ICA dissection caused by an elongated styloid process has been reported frequently. Eagle's syndrome is rare but is one of the important diseases to consider in the differential diagnosis of extracranial carotid artery dissection.

著者

竹島 秀雄 KAKU Takayuki USHIO Yukitaka

出版者

日本脳神経外科学会

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

vol.39, no.3, pp.242-245, 1999-03-15

被引用文献数

11

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自然退縮を示した神経梅毒(ゴム腫)の1例を報告する。症例は75歳男性、頭痛で発症した。MRIのT1, T2強調画像ともに低信号を示し、Gd投与でリング状に増強される、硬膜と癒着した病変を右後 頭葉に認めた。経過中、ステロイドや抗生物質を投与しなかったにもかかわらず、画像上自然退縮を認めたため、悪性リンパ腫の術前診断で摘出を行った二ところが、組織学的には非特異的肉芽腫で、髄液中のTPHA反応が強陽性、抗生物質の投与にて約4カ月で病変が消失したことよりゴム腫の診断が確定した。近年AIDSの増加とともに神経梅毒は増加しており、硬膜を巻き込んだ腫瘍では自然退縮を認めても、ゴム腫を鑑別診断として考慮すべきである。