A 51-year-old man who presented with acute onset aphasia, right sided weakness - Case Report

Abstract Introduction Acute internal carotid artery (ICA) occlusions have a precise differential, of which includes Eagle’s Syndrome, which is due to disfigured or elongated styloid processes. This can result in 1) unilateral oropharyngeal, facial and auricular pain due to irritation of the glossopharyngeal nerve or 2) carotid artery dissection. In this report, we highlight the diagnostic/management approach to the latter. Case Presentation A 51-year-old man presented with acute onset aphasia and right sided weakness, was found to have a L ICA occlusion and on further review to have a R ICA occlusion in the past. Ultimately, workup was consistent with bilateral carotid artery dissections – Eagle’s Syndrome. Conclusions Bilateral Eagle’s Syndrome is an extremely care condition, and this case report highlights the diagnostic/management considerations, especially as it relates to the utilization of multiple imaging modalities.