title: Bilateral Eagle Syndrome with Associated Internal Carotid Artery Kinking and Significant Stenosis.
abstract: BACKGROUND
  Eagle syndrome represents elongated styloid process characterized by calcification and ossification of the stylohyoid ligament rarely associated with the pathology of carotid arteries. We are presenting a very rare case of bilateral Eagle syndrome with associated internal carotid artery (ICA) kinking on the right side and significant ICA stenosis on the left side.
  
  
  METHODS
  A 62-year-old female patient was admitted to our Institution for multidetector computed tomography (MDCT) angiography. Two years ago, she experienced stroke with right-sided weakness, color Doppler scan of carotid arteries described left ICA stenosis of 75% and right ICA stenosis of 50%. MDCT arteriography revealed bilateral Eagle syndrome associated with significant left ICA stenosis of >90% and right ICA kinking. Left carotid endarterectomy was performed followed by elongated styloid process resection that was in close relationship to ICA. Even more significant relationship was seen on the right side involving right ICA kinking and elongated styloid process that was treated conservatively. Postoperative course was uneventful; after 6 months, the patient was doing well.
  
  
  CONCLUSIONS
  This is the first case that describes bilateral Eagle syndrome associated with ICA kinking on one side and significant stenosis on the other. Although rare, this syndrome should be thought of in symptomatic patients with carotid pathologies in which case computed tomography angiography is of crucial importance.
authors.affiliation: Vascular Surgery Clinic, Department of Vascular Surgery, "Dedinje" Cardiovascular Institute, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Djordje
authors.initials: D
authors.lastname: Radak
authors.affiliation: Vascular Surgery Clinic, Department of Vascular Surgery, "Dedinje" Cardiovascular Institute, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia. Electronic address: drslobex@yahoo.com.
authors.forename: Slobodan
authors.initials: S
authors.lastname: Tanaskovic
authors.affiliation: Clinic for Radiology, Department of Radiology, "Dedinje" Cardiovascular Institute, Belgrade, Serbia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Kecmanovic
authors.affiliation: Vascular Surgery Clinic, Department of Vascular Surgery, "Dedinje" Cardiovascular Institute, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Srdjan
authors.initials: S
authors.lastname: Babic
authors.affiliation: Vascular Surgery Clinic, Department of Vascular Surgery, "Dedinje" Cardiovascular Institute, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Petar
authors.initials: P
authors.lastname: Popov
authors.affiliation: Vascular Surgery Clinic, Department of Vascular Surgery, "Dedinje" Cardiovascular Institute, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Predrag
authors.initials: P
authors.lastname: Gajin
mesh_terms: D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D000072226:Computed Tomography Angiography; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009999:Ossification, Heterotopic / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D012720:Severity of Illness Index; D013701:Temporal Bone / Q000002:abnormalities* / Q000601:surgery; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color