Symptomatic carotid stenosis in Eagle syndrome managed with traditional endarterectomy and styloidectomy

Eagle syndrome represents an anatomic variant present in 4% of the population. It is characterized by an elongated styloid process or ossified stylohyoid ligament with resultant irritation of cervical neurovascular structures. Common manifestations include craniofacial or cervical pain related to compression of the glossopharyngeal nerve. In rare cases, patients can present with a stroke or transient ischemic attack due to associated carotid artery injury. Fewer than 25 prior case reports describe vascular symptoms in the setting of associated carotid artery dissection and, in one case, a pseudoaneurysm. Our case report details the diagnosis and management of symptomatic carotid artery stenosis secondary to vascular Eagle syndrome.