Neurological Surgery 脳神経外科46巻1号

2018年01月発行

症例

両側頚部内頚動脈解離を来した茎状突起過長症の1例

著者： 瀧野透¹ 渋間啓¹ 金丸優¹ 岡村光司² 大島章² 田澤真奈美² 梨本岳雄¹ 土屋尚人¹ 吉村淳一¹ 根津公教² 斎藤隆史¹

所属機関： ¹長野赤十字病院脳神経外科 ²長野赤十字病院耳鼻咽喉科

ページ範囲：P.53 - P.59

Ⅰ．はじめに
　茎状突起過長症（Eagle症候群）は，咽頭喉頭周囲の違和感や疼痛などの症状を呈する疾患として，Eagleにより1937年に初めて報告された²⁾．これまで多くの報告がなされているが，過長した茎状突起が頚部内頚動脈を圧迫し，虚血性脳卒中を呈することはあまり知られていない．今回われわれは，両側頚部内頚動脈解離を契機に診断された茎状突起過長症の手術例を経験したので報告する．

参考文献

1) Chuang WC, Short JH, McKinney AM, Anker L, Knoll B, McKinney ZJ：Reversible left hemispheric ischemia secondary to carotid compression in Eagle syndrome：surgical and CT angiographic correlation. AJNR Am J Neuroradiol 28：143-145, 2007

2) Eagle WW：Elongated styloid processes：report of two cases. Arch Otolaryngol 25：584-587, 1937

3) Eagle WW：Elongated styloid process；symptoms and treatment. AMA Arch Otolaryngol 67：172-176, 1958

4) Eagle WW：The symptoms, diagnosis and treatment of the elongated styloid process. Am Surg 28：1-5, 1962

5) Faivre A, Abdelfettah Z, Rodriguez S, Nicoli F：Neurological picture. Bilateral internal carotid artery dissection due to elongated styloid processes and shaking dancing. J Neurol Neurosurg Psychiatry 80：1154-1155, 2009

6) Farhat HI, Elhammady MS, Ziayee H, Aziz-Sultan MA, Heros RC：Eagle syndrome as a cause of transient ischemic attacks. J Neurosurg 110：90-93, 2009

7) 宮田　悠，中原一郎，太田剛史，松本省二，定政信猛，石橋良太，五味正憲，坂　真人，岡田卓也，西　秀久，園田和隆，高下純平，渡邉定克，永田　泉：頚部内頚動脈解離による脳梗塞を繰り返した茎状突起過長症に対して急性期血行再建術と茎状突起摘出術を施行した1例．脳卒中の外科44：145-150, 2016

8) Muthusami P, Kesavadas C, Sylaja PN, Thomas B, Harsha KJ, Kapilamoorthy TR：Implicating the long styloid process in cervical carotid artery dissection. Neuroradiology 55：861-867, 2013

9) Ogura T, Mineharu Y, Todo K, Kohara N, Sakai N：Carotid artery dissection caused by an elongated styloid process：three case reports and review of the literature. NMC Case Rep J 2：21-25, 2015

10) Ohara N, Sakaguchi M, Okazaki S, Nagano K, Kitagawa K：Internal carotid artery dissection caused by an elongated styloid process：usefulness of transoral ultrasonography. J Stroke Cerebrovasc Dis 21：918. e7-8, 2012

11) Raser JM, Mullen MT, Kasner SE, Cucchiara BL, Messé SR：Cervical carotid artery dissection is associated with styloid process length. Neurology 77：2061-2066, 2011

12) Razak A, Short JL, Hussain SI：Carotid artery dissection due to elongated styloid process：a self-stabbing phenomenon. J Neuroimaging 24：298-301, 2014

13) Renard D, Azakri S, Arquizan C, Swinnen B, Labauge P, Thijs V：Styloid and hyoid bone proximity is a risk factor for cervical carotid artery dissection. Stroke 44：2475-2479, 2013

14) Soo OY, Chan YL, Wong KS：Carotid artery dissection after prolonged head tilting while holding a newborn baby to sleep. Neurology 62：1647-1648, 2004

15) Sveinsson O, Kostulas N, Herrman L：Internal carotid dissection caused by an elongated styloid process（Eagle syndrome). BMJ Case Rep, 2013. doi：10.1136/bcr-2013-009878

16) Todo T, Alexander M, Stokol C, Lyden P, Braunstein G, Gewertz B：Eagle syndrome revisited：cerebrovascular complications. Ann Vasc Surg 26：729. e1-5, 2012

17) Tubbs RS, Loukas M, Dixon J, Cohen-Gadol AA：Compression of the cervical internal carotid artery by the stylopharyngeus muscle：an anatomical study with potential clinical significance. Laboratory investigation. J Neurosurg 113：881-884, 2010

18) Yamamoto S, Todo K, Kawamoto M, Kohara N：Carotid artery dissec-tion associated with an elongated styloid process. Intern Med 52：1005-1006, 2013

19) Zuber M, Meder JF, Mas JL：Carotid artery dissection due to elongated styloid process. Neurology 53：1886-1887, 1999