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。神经外科医师极少接诊该病，但该病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，其表现为罕见的神经血管受累及异常临床症状。这些患者的诊疗方案涵盖自限性事件后的回顾性诊断、抗血小板治疗、血管内介入及外科手术干预。尽管外伤骨折、脊柱推拿及既往颈部手术史被认为是伊格尔综合征的诱因，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，其过长可导致10%的患者出现相关症状。尽管该病更多由耳鼻喉科医师接诊，但临床医师对这一虽罕见却具有潜在危险性的疾病提高认识，有助于在茎突过长为致病原因时减少诊断延误，因为此类患者往往需要接受手术治疗。