scholarly journals ANCA-Negative Granulomatosis with Polyangiitis Presenting with Hypertrophic Cranial Pachymeningitis, Abducens Nerve Palsy, and Stenosis of the Internal Carotid Artery

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Shohei Harabuchi ◽  
Nobuyuki Bandoh ◽  
Rika Yasukawa ◽  
Michihisa Kono ◽  
Takashi Goto ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Nerve Palsy ◽  
Granulomatosis With Polyangiitis ◽  
Internal Carotid ◽  
Abducens Nerve ◽  
Abducens Nerve Palsy ◽  
History Of ◽  
The Right ◽  
Hypertrophic Cranial Pachymeningitis

We report a rare case of granulomatosis with polyangiitis (GPA) presenting with hypertrophic cranial pachymeningitis (HCP), abducens nerve palsy, and stenosis of the internal carotid artery (ICA). A 59-year-old Japanese man presented with a year history of nasal obstruction and a 2-month history of slight headache. Histopathological examination of the granulomatous mucosa in the ethmoid sinuses resected by endoscopic sinus surgery revealed necrotizing vasculitis with multinucleated giant cells. The patient was diagnosed with the limited form of GPA as a result of the systemic examination. He declined immunosuppressive treatment. Eighteen months after the diagnosis of GPA, he presented with diplopia and severe headache. Though nasal findings indicating GPA were not observed in the nasal cavity, CT scan revealed a lesion of the right sphenoid sinus eroding the bone of the clivus. Gadolinium-enhanced MRI of the brain showed thickening of the dura mater around the right cavernous sinus and clivus. Magnetic resonance angiography and cerebral angiography revealed narrowing at the C5 portion of the ICA. Intravenous methylprednisolone pulse therapy followed by oral prednisolone and cyclophosphamide resolved headache and dramatically improved HCP and stenosis of the ICA.

scholarly journals Teaching NeuroImages: Abducens Nerve Palsy With Ipsilateral Excessive Eye Tearing Attributed to an Internal Carotid Artery Sympathetic Plexus Schwannoma

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012183
Author(s):  
Lina Palaiodimou ◽  
Stefanos Lachanis ◽  
Eleni Bakola ◽  
Panagiotis Zis ◽  
Evangelia Kararizou ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Abducens Nerve ◽  
Abducens Nerve Palsy

Internal Carotid Artery Pseudoaneurysm Causing an Abducens Nerve Palsy

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Alexander S. Himstead ◽  
Kevin M. Gustafson ◽  
Anton N. Hasso ◽  
Lilangi S. Ediriwickrema
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Abducens Nerve ◽  
Abducens Nerve Palsy ◽  
Artery Pseudoaneurysm

scholarly journals Stylocarotid syndrome: A case report

2008 ◽  
Vol 136 (11-12) ◽  
pp. 650-653 ◽  
Author(s):  
Branko Petrovic ◽  
Djordje Radak ◽  
Vladimir Kostic ◽  
Nadezda Covickovic-Sternic
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Longitudinal Axis ◽  
Original Description ◽  
Styloid Process ◽  
Head Movements ◽  
Head Turning ◽  
History Of ◽  
The Right

INTRODUCTION The American otolaryngologist Eagle was the first to describe styloid syndrome in 1937 and the syndrome was named after him (Eagle's syndrome). The original description of two separate syndromes is connected with his name: classical syndrome, which almost constantly occurs after tonsillectomy and carotid artery syndrome, which occurs without tonsillectomy and also in cases when stylohyoid complex compresses the carotid segments and perivascular sympathetic fibers. In the following years, two more syndromes were defined: stylohyoid and pseudostylohyoid, which according to their manifestations, correspond to the genuine classical form. CASE OUTLINE A 40-year old male is presented, with a history of 3-year duration of pains in the upper part of the left side of the neck, in the left eye and its surroundings. Pain occurrences were not regular. Throbbing pains were most often provoked by sudden head movements and neck compression. He was healthy until the onset of these problems. The findings of all examinations were normal. The applied prophylactic therapy, typical for cluster headache, was without any effect. On 64-MSCT (multislice computed tomography), the neck arteries did not show any intraluminal pathology. The styloid processes were of normal length. On the left side, the styloid process tip pressed the internal carotid artery disturbing its longitudinal axis. CONCLUSION In our presentation, the defined lengths of the styloid processes were normal. The medial angulation of the left styloid process was more expressed reaching 63.5 degrees (the right side angulation was normal). Persistent and throbbing pain in the region of the left eye with backward projection suggested compression on the internal carotid artery. Pains were most frequently provoked by head turning and neck compression. 64-MSCT diagnostics enabled us to determine the characteristics of styloid processes and their relation to the internal carotid artery. Improvement was achieved by administration of anti-epileptic (gabapentin) and antidepressant (amitriptyline) drugs.

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