An unusual case of ischemic stroke resulting from hyoid bone compression of the internal carotid artery

Vascular compression by osteocartilaginous structures, such as the hyoid bone, is an underrecognized cause of ischemic stroke, often referred to as "bony stroke." Due to its rarity, this condition presents a significant diagnostic challenge, requiring meticulous imaging to identify the underlying structural abnormalities. We report an intriguing case of a 40-year-old female presenting with an acute embolic ischemic stroke. Diagnostic imaging revealed compression of the right internal carotid artery by the greater horn of the hyoid bone, causing arterial stagnation in both neutral and rotated neck positions, which resolved after surgical decompression. Through this case, we emphasize the importance of a comprehensive evaluation of osteocartilaginous cervical structures surrounding the brain-supplying arteries, as they represent a rare yet treatable cause of ischemic stroke.