A 70 YEAR OLD MAN WITH APHASIA AND RIGHT SIDED HEMIPLEGIA.

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A 70 YEAR OLD MAN WITH APHASIA AND RIGHT SIDED HEMIPLEGIA. Teaching NeuroImages Neurology Resident and Fellow Section © 2016 American Academy of Neurology

Vignette A 70 -year old man developed acute onset of aphasia and right sided hemiplegia in the setting of mild hypotension after hemodialysis. Kavi, et al © 2016 American Academy of Neurology

Imaging CT angiogram showing elongated styloid process on left causing compression of left Internal Carotid artery extracranially (Image A, B, and C). MRI Brain showing restricted cortical diffusion in left ACA and MCA territory sparing the white matter, with corresponding hypointensity on ADC sequence (Image D and E) Kavi, et al © 2016 American Academy of Neurology

Eagle’s syndrome: Cerebrovascular complications Eagle’s syndrome is primarily an otorhinolaryngologic condition characterized by odynophagia and cervicofacial pain due to an elongated or ossified stylohyoid ligament.1 Ipsilateral head turn or relative systemic hypoperfusion may precipitate focal cerebral hypoperfusion and ischemia.2 A comprehensive workup for stroke etiology was otherwise unremarkable. 1) Eagle WW. Elongated styloid process. Arch Otolaryngol. 1937;25:584-7. 2) Todo T, Alexander M, Stokol C, Lyden P, Braunstein G, Gewertz B. Eagle syndrome revisited: cerebrovascular complications. Ann Vasc Surg. 2012 Jul;26(5):729.e1-5 Kavi, et al © 2016 American Academy of Neurology