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Is there a potential role for hyoid bone compression in pathogenesis of carotid artery stenosis?

O S Abdelaziz1, C S Ogilvy, M Lev

  • 1Neurosurgery Department, Faculty of Medicine, Alexandria University, Egypt.

Surgical Neurology
|June 16, 1999
PubMed

Insights

Hyoid bone compression may contribute to atherosclerotic carotid stenosis. Surgical intervention and CT angiography confirmed its role in this rare case of carotid artery disease.

Area of Science:

  • Vascular Surgery
  • Cardiovascular Medicine
  • Radiology

Background:

  • Atherosclerosis pathogenesis involves hemodynamic factors like blood flow turbulence and shear stress.
  • These factors are particularly significant at arterial wall sites with sudden changes.
  • Hyoid bone protrusion into carotid vessels is investigated as a potential contributor.

Observation:

  • An 85-year-old woman presented with transient ischemic attack symptoms.
  • Imaging revealed 90% stenosis of the right internal carotid artery.
  • Intraoperative findings showed the hyoid bone projecting into the internal carotid artery, causing indentation and vessel rotation.

Findings:

  • Surgical resection of the hyoid bone and carotid endarterectomy were performed.
  • Postoperative CT angiography confirmed hyoid bone resection and carotid artery repositioning.
  • This case suggests hyoid bone compression as a contributing factor to atherosclerotic carotid stenosis.

Implications:

  • Hyoid bone compression should be considered in the differential diagnosis of carotid artery stenosis.
  • CT angiography is valuable for assessing carotid artery occlusive disease and anatomical variations.
  • Understanding unusual anatomical causes can improve diagnosis and treatment of cerebrovascular disease.
Abstract

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