Neurosurgical management of vascular compression presenting as visual symptoms secondary to elongated styloid processes (Eagle syndrome)

Eagle syndrome (ES) was first described in 1937, to characterize elongation of the styloid process. It is rarely encountered by neurosurgeons but does present the potential for vascular sequelae and neurological complications. We discuss three patients with uncommon presentations of neurovascular compromise with uncommon symptomatology, secondary to ES. Their management ranged from retrospective diagnoses following self-limited events, antiplatelet therapy, and endovascular and surgical interventions. While traumatic fractures, chiropractic manipulation, and history of prior neck surgery have been implicated as the etiologies for ES, congenital cases are common. The styloid process intimately interplays with adjacent neurovascular and nervous structures; its elongation can cause symptoms in 10% of patients. Awareness of this potentially dangerous but rare disease – more commonly seen by our otolaryngology colleagues – may help reduce diagnostic delays when an elongated styloid process is the cause, as surgery may be required.

伊格尔综合征（Eagle syndrome, ES）于1937年首次被报道，用以描述茎突过长的病症。该病症在神经外科临床中较为少见，但存在引发血管后遗症与神经并发症的潜在风险。本文报告3例继发于伊格尔综合征的患者，其神经血管受累表现及临床症状均较为罕见。患者的诊疗方案差异显著，涵盖自限性事件后的回顾性诊断、抗血小板治疗、血管内介入治疗及外科手术干预。尽管创伤性骨折、整脊手法操作及既往颈部手术史被认为是伊格尔综合征的诱发因素，但先天性病例更为常见。茎突与邻近的神经血管及神经结构紧密毗邻并相互作用，约10%的患者会因茎突过长出现相关临床症状。尽管该病更多见于耳鼻咽喉头颈外科医师的临床工作中，但临床医师对这一虽罕见却具有潜在危险性的病症提高认知，有助于在茎突过长为致病原因时减少诊断延误，毕竟此类情况往往需要外科手术干预。