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Styloid and hyoid bone proximity is a risk factor for cervical carotid artery dissection

Dimitri Renard1, Souhayla Azakri, Caroline Arquizan

  • 1Department of Neurology, Hôpital Caremeau, France. dimitrirenard@hotmail.com

Stroke
|August 3, 2013
PubMed

Insights

Shorter distances between the styloid process and the internal carotid artery (ICA) are significant risk factors for carotid artery dissection (CAD). Proximity of the hyoid bone to the ICA may also contribute to CAD risk.

Area of Science:

  • Vascular anatomy
  • Cranial nerve anatomy
  • Cerebrovascular disease

Background:

  • Carotid artery dissection (CAD) is increasingly associated with elongated styloid processes.
  • The anatomical relationship between the styloid process, hyoid bone, and internal carotid artery (ICA) in CAD is not fully understood.

Purpose of the Study:

  • To investigate whether the proximity of the styloid process and hyoid bone to the ICA is a risk factor for CAD.
  • To quantify the distances between these anatomical structures in patients with and without CAD.

Main Methods:

  • Retrospective analysis of computed tomography angiograms from 88 patients with nonaneurysmal CAD.
  • Comparison with 88 age- and sex-matched controls without dissection and 32 nonaneurysmal vertebral artery dissection controls.
  • Blinded measurement of the shortest distance between the ICA and the styloid and hyoid bones.

Main Results:

  • Significantly shorter styloid-ICA and hyoid-ICA distances were observed on the side of CAD compared to controls.
  • Styloid-ICA distances were shorter in CAD patients on both sides compared to non-dissection and vertebral artery dissection controls.
  • Direct mechanical contact between the styloid process and the ICA was more frequent in CAD patients.

Conclusions:

  • Reduced proximity of the styloid process to the ICA is a key risk factor for CAD.
  • The hyoid bone's proximity to the ICA may also play a role in CAD development.
  • Further research is warranted to elucidate the mechanism of dissection, potentially involving direct injury to the carotid artery wall.
Abstract

Keywords:
carotid arteriesdissectionhyoid bonestyloid

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