Mastication Steal Syndrome.
A 56-year-old woman presented with episodic vertigo, dizziness, and diplopia during meals and prolonged verbal presentations at work. Subsequent work-up included an eventual catheter-based angiogram revealing an ostial left external carotid artery (ECA) occlusion with reconstituted retrograde flow via a variant collateral branch from the dominant left vertebral artery. The findings demonstrate that repetitive activities involving craniofacial muscular systems supplied by the ECA result in a symptomatic arterial steal syndrome via the enhanced diverted flow from the collateral vertebral-basilar arterial system. A left ECA endarterectomy with reimplantation of the vessel was performed, and the patient has been episode free thereafter.
Department of Surgery, University of Oklahoma College of Medicine, Tulsa, OK. Electronic address: charles-maliska@ouhsc.edu.
Charles Miles
CM
Maliska
Department of Surgery, University of Oklahoma College of Medicine, Tulsa, OK.
John
J
Blebea
Department of Surgery, University of Oklahoma College of Medicine, Tulsa, OK.
Kevin E
KE
Taubman
D000792:Angiography; D002342:Carotid Artery, External / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D016893:Carotid Stenosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D003097:Collateral Circulation; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D008409:Mastication; D008875:Middle Aged; D012039:Regional Blood Flow; D012092:Replantation; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology