Bilateral carotid dissection due to Eagle syndrome: case report

Eagle Syndrome (ES), characterized by elongation of the styloid process (ESP), is a rare condition with diverse symptoms. Among its complications, carotid dissection is a significant outcome requiring accurate diagnosis and intervention. This study describes a case of bilateral carotid dissection associated with ES, emphasizing diagnostic challenges, management, and therapeutic approaches. Conducted under Research Ethics Committee protocol 68193123.5.0000.0119 and approval number 6.028.970, it reports on a 38-year-old woman with a 5-day history of left-sided headache, otalgia, syncope, right-hand limitation, and visual blurring. MRI revealed left carotid bulb occlusion and recent ischemic events, while angio-CT confirmed bilateral carotid dissections. After clinical management failed, an intraoral surgical approach was chosen, resulting in full neurological recovery. CT confirmed ESP, and genetic testing was negative. This case highlights the need to consider ES in atypical cervicofacial symptoms, given its underdiagnosed incidence (~4% for ESP; ~0.16% for ES), reinforcing the importance of better clinical guidelines.