title: Successful treatment of cold-induced neck pain and jaw claudication with revascularization of severe atherosclerotic external carotid artery stenoses.
abstract: OBJECTIVE
  To present a patient whose cold-triggered neck pain and jaw claudication remitted after revascularization of severe atherosclerotic stenoses of both external carotid arteries (ECA).
  
  
  METHODS
  A 60-year-old vintner presented with jaw claudication and neck pain that increased in severity while he worked in cold temperatures. Angiography showed severe atherosclerotic narrowing of both ECAs. The symptoms disappeared after staged, bilateral percutaneous transluminal angioplasty procedures. However, the pain recurred together with severe bilateral ECA restenoses 6 months later; once again, the pain remitted after redilation. Right-sided neck pain and severe ECA narrowing recurred 5 months later and resolved after carotid endarterectomy. The patient remained asymptomatic and showed no ECA stenosis during a 3-year follow-up.
  
  
  CONCLUSIONS
  Cold-triggered neck pain may be a symptom of atherosclerotic ECA stenoses, and carotid revascularization may be an efficient and safe treatment.
authors.affiliation: Department of Neurology, University Hospital Zurich, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schiller
authors.forename: Urs
authors.initials: U
authors.lastname: Schwarz
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schuknecht
authors.forename: Dieter
authors.initials: D
authors.lastname: Mayer
authors.forename: Klaus
authors.initials: K
authors.lastname: Hess
authors.forename: Ralf W
authors.initials: RW
authors.lastname: Baumgartner
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D002342:Carotid Artery, External / Q000000981:diagnostic imaging / Q000601:surgery; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D003080:Cold Temperature / Q000009:adverse effects*; D016894:Endarterectomy, Carotid; D006801:Humans; D007571:Jaw Diseases / Q000209:etiology* / Q000628:therapy; D008297:Male; D019547:Neck Pain / Q000209:etiology* / Q000628:therapy; D011859:Radiography; D012008:Recurrence; D012720:Severity of Illness Index; D016896:Treatment Outcome