Eagle syndrome and vascular complications
Reviewed by Stuart Clark

Eagle syndrome is characterised by an elongated styloid process, which is anatomically positioned between the external carotid artery laterally and the internal carotid artery and internal jugular vein medially. As a result, vessel impingement can be exacerbated by head movements, potentially leading to complications such as internal carotid artery dissection, transient ischemic attack (TIA), cerebrovascular accident (CVA), jugular thrombosis or intracranial hypertension due to jugular compression. This systematic review identified 231 patients with vascular complications. Arterial impingement was observed in 67% of cases, with 46% of these patients experiencing a CVA. Venous impingement was present in 32% of cases, of which 68% reported chronic headaches. Among the 79 patients who underwent styloidectomy as the initial treatment, nearly 80% were cured, 19% showed improvement and only 2.5% experienced recurrence. In contrast, of the 106 patients initially treated medically without styloidectomy, 24% were cured, 28% improved and 47% had a recurrence. The authors acknowledge the limitations of the available evidence, as most studies included were case reports or case series, with only four retrospective studies. They also highlight a lack of comprehensive data and potential publication bias. Nevertheless, their findings support what we already knew – that styloidectomy remains the preferred treatment for Eagle syndrome with vascular complications. 

Eagle syndrome and vascular complications – a systemic review.
Thielen A, Brizzi V, Majoufre C, et al.
INT J ORAL MAXILLOFAC SURG
2024;5(1):31–42.