We present a case of
Eagle syndrome in a 77-year-old woman with associated
aneurysm and nontraumatic styloid process fracture, without history of
tonsillectomy, who presented to the emergency department. The first set of symptoms associated with the elongation of the temporal styloid process and/or the calcification of the stylomandibular or stylohyoid ligaments was described by Eagle in 1937. Classically, unilateral
pain in the oropharynx radiating to the neck and face that is exacerbated by head turning and neck rotation is characteristic of
Eagle syndrome. However, styloid process elongation and stylohyoid calcification found in
Eagle syndrome may also present with vascular symptomsthrough impingement and injury of the carotid arteries.
Eagle syndrome is a rare but important differential that the emergency physician must consider in a patient with unilateral
neck pain and positional neurological symptoms with head turning and in posttonsillectomy patients. Patients with medical history of
Eagle syndrome presenting with
neck pain and especially neurological symptomsmust be thoroughly evaluated for carotid and jugular venous injury. Specifically, the decision to obtain computed tomography and computed tomographic angiography to evaluate for
carotid artery injury is important for patient management and disposition.