Carotidynia
From Wikipedia, the free encyclopedia
Drawing from Gray's anatomy with blue arrow showing the bifurcation area which is painful in Carotidynia.
Carotidynia is a syndrome characterized by unilateral (one-sided) tenderness of the carotid artery, near the bifurcation. It was first described in 1927 by Temple Fay.[1] The most common cause of carotidynia may be migraine, and then it is usually self-correcting. Common migraine treatments may help alleviate the carotidynia symptoms. Recent histological evidence has implicated an inflammatory component of carotidynia, but studies are limited.[2] Carotid arteritis is a much less common cause of carotidynia, but has much more serious consequences. It is a form ofgiant cell arteritis, which is a condition that usually affects arteries in the head. Due to this serious condition possibly causing carotidynia, and the possibility that neck pain is related to some other non-carotidynia and serious condition, the case should be investigated by a medical doctor.[3]Because carotidynia can be caused by numerous causes, Biousse and Bousser in 1994 recommended the term not be used in the medical literature.[4] However, recent MRI and ultrasound studies have supported the existence of a differential diagnosis of carotidynia consistent with Fay's characterization.[5][6]
References
- Hill and Hastings list this reference as: Fay, Temple (1927) "Atypical neuralgia." Arch Neurol Psychiatry.
- Upton, P.; Smith, J. G.; Charnock, D. R. (2003). "Histologic confirmation of carotidynia". Otolaryngology - Head and Neck Surgery. 129 (4): 443–444. doi:10.1016/S0194-5998(03)00611-9. PMID 14574303.
- Hill LM, Hastings G (1994). "Carotidynia: a pain syndrome.". J Fam Pract. 39 (1): 71–5. PMID 8027735.
- Biousse V, Bousser MG (1994). "The myth of carotidynia.". Neurology. 44 (6): 993–5. doi:10.1212/wnl.44.6.993. PMID 8208434.Available here
- Lee TC, Swartz R, McEvilly R, Aviv RI, Fox AJ, Perry J, Symons SP. CTA, MR and MRA imaging of carotidynia: case report. Canadian Journal of Neurological Sciences. 2009 May; 36(3):373-375.
- Kuhn, J.; Harzheim, A.; Horz, R.; Bewermeyer, H. (2006). "MRI and ultrasonographic imaging of a patient with carotidynia". Cephalalgia. 26 (4): 483–485. doi:10.1111/j.1468-2982.2006.01053.x. PMID 16556251.
External links
- Family Practice notebook.com
- Blog assessing whether carotidynia is a valid medical diagnosis.
- Carotidynia condition page on PatientsLikeMe.
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Case Rep Vasc Med. doi: 10.1155/2013/585789
Carotidynia Possibly due to Localized Vasculitis in a Patient with Latent Mycobacterium tuberculosis Infection.
Cassone G1, Colaci M1, Giuggioli D1, Manfredi A1, Sebastiani M1, Ferri C1.
Author information
1Chair and Rheumatology Unit, University of Modena and Reggio Emilia, Medical School, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Via del Pozzo 71, 41100 Modena, Italy.
Abstract
Carotidynia is a syndrome characterized by tenderness of the carotid artery near the bifurcation due to numerous, heterogeneous causes. Here we reported the case of a 31-year-old Moroccan woman with right-sided neck pain and tenderness with irradiation to ipsilateral ear, eye, and occipital region. Clinical symptoms and imaging findings were suggestive of primary variant of carotidynia syndrome. In particular, color-Doppler ultrasonography revealed a concentric wall thickening of the distal common carotid artery, while thoracic magnetic resonance showed localized perivascular enhancement of the soft tissue in the right medial-distal common carotid artery in T1-weighted images, without intraluminal diameter variation. Moreover, careful clinicoserological and imaging investigations (cranial, cervical, and thoracic angiocomputed tomography and magnetic resonance) excluded well-known disorders potentially responsible for carotidynia syndrome. The patient was scarcely responsive to nonsteroidal anti-inflammatory drugs, but clinical symptoms resolved after three months. Of interest, the patient showed latent Mycobacterium tuberculosis infection (positive tuberculosis interferon-gamma release assay; QuantiFERON-TB Gold); this finding suggested a possible triggering role of mycobacterial antigens in the immune-mediated mechanism responsible for localized carotid injury.
PMID: 24363952
J Stroke Cerebrovasc Dis. doi: 10.1016/j.jstrokecerebrovasdis.2012.10.011
Contralateral recurrence of carotidynia during steroid therapy.
Inatomi Y1, Nakajima M2, Yonehara T3, Hirano T4.
Author information
1Department of Neurology, Saiseikai Kumamoto Hospital, Kumamoto, Japan. Electronic address: y.inatomix@silk.ocn.ne.jp.
2Department of Neurology, Saiseikai Kumamoto Hospital, Kumamoto, Japan; Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada.
3Department of Neurology, Saiseikai Kumamoto Hospital, Kumamoto, Japan.
4Department of Internal Medicine III, Faculty of Medicine, Oita University, Oita, Japan.
Abstract
A 44-year-old woman presented with contralateral recurrence of carotidynia during steroid therapy at 1 month after onset. Carotidynia can present with a multiphasic clinical course and can affect the neck bilaterally. Therefore, patients with carotidynia should be observed even after remission.
Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.
KEYWORDS:
Carotidynia; arteritis; carotid artery; magnetic resonance imaging; temporal arteritis; ultrasonography
PMID: 23253536
Wien Klin Wochenschr. doi: 10.1007/s00508-014-0633-2
A pain in the throat: a 19-year history of symptoms relating to the carotid artery.
Elkins A1, Barakate M, Henderson J, Grieve S.
Author information
1School of Medicine, The University of New South Wales, Sydney, NSW, Australia.
Abstract
A 38-year-old man presented with a 19-year history of sore throat and an ache radiating from the centre of the anterior neck to the both ears and the occiput. Computed tomography angiography revealed a tortuous submucosal right internal carotid artery, which was causing tonsillar displacement. The diagnosis of carotidynia has a controversial history within the literature and is currently not accepted as a distinct pathological entity by the International Headache Society. In this patient, the clinical and imaging features, in addition to the absence of any other pathology confers support to the diagnosis of carotidynia.
PMID: 25398291
Clin Imaging. 2015 Mar-Apr;39(2):305-7. doi: 10.1016/j.clinimag.2014.12.001
CT findings in a patient with bilateral metachronous carotidynia.
Young JY1, Hijaz TA2, Karagianis AG2.
Author information
1Northwestern Memorial Hospital, Department of Radiology, Neuroradiology Section, 251 East Huron Street, Chicago, IL, 60611. Electronic address: joseph.y.young@gmail.com.
2Northwestern Memorial Hospital, Department of Radiology, Neuroradiology Section, 251 East Huron Street, Chicago, IL, 60611.
Abstract
Carotidynia is a self-limiting, idiopathic clinical syndrome characterized by acute unilateral neck pain and tenderness of the carotid artery. We describe a unique case of bilateral carotidynia that occurred metachronously, with each incident resolving without long-term sequelae. Knowledge of this entity is important to properly interpret the imaging findings and to not mistake this finding as an ill-defined tumor, thus avoiding unnecessary biopsy.
Copyright © 2015 Elsevier Inc. All rights reserved.KEYWORDS:CT; Carotidynia; inflammation; neck; pain.PMID: 25575581
J Mal Vasc. 2015 Dec;40(6):395-8. doi: 10.1016/j.jmv.2015.06.001
Comparative evolution of carotidynia on ultrasound and magnetic resonance imaging.
Behar T1, Menjot N2, Laroche JP3, Böge B3, Quéré I3, Galanaud JP3.
Author information
1Clinical investigation center and department of internal medicine, hôpital de Montpellier, university hospital, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France. Electronic address: t-behar@chu-montpellier.fr.
2Department of neuroradiology, university hospital, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France.
3Clinical investigation center and department of internal medicine, hôpital de Montpellier, university hospital, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France.
Abstract
Carotidynia is rare and associates neck pain with tenderness to palpation usually over the carotid bifurcation, the diagnosis of which is based on magnetic resonance imaging (MRI). Ultrasounds (US) are also frequently used but their accuracy in predicting the course of the disease is unknown. We are reporting the case of a 52-year-old man who presented a typical carotidynia. Clinical symptoms, ultrasound and MRI imaging evolution were closely correlated. Our case suggest that after a first MRI to set a positive diagnosis of carotidynia and exclude differential diagnoses, US which is more widely available and less expensive could constitute the imaging of reference for the follow-up.
Copyright © 2015 Elsevier Masson SAS. All rights reserved.KEYWORDS:Carotidynia; Carotidynie; Follow-up; Imagerie par résonance magnétique; Magnetic resonance imaging; Suivi; Ultrasonography; Échographie.PMID: 26163344
Vasc Endovascular Surg. 2017 Apr;51(3):149-151. doi: 10.1177/1538574417697212.
Idiopathic Carotidynia.
Policha A1, Williams D2, Adelman M1, Veith F1, Cayne NS1.
Author information
1
1 Division of Vascular and Endovascular Surgery, New York University Langone Medical Center, New York, NY, USA.
2
2 Department of General Surgery, New York University Langone Medical Center, NY, USA.
Abstract
Idiopathic carotidynia is a syndrome characterized by pain and tenderness over the carotid artery without an associated structural luminal abnormality. Controversy exists over whether this is a distinct disease entity or merely a symptom attributable to other causes of neck pain, such as carotid dissection or vasculitis. A 50-year-old woman presented with sudden-onset right neck pain. Imaging studies demonstrated transmural inflammation of the proximal internal carotid artery, without evidence of intraluminal pathology. The patient was placed on low-dose aspirin and ibuprofen. Her symptoms resolved within a week. At 3-month follow-up, her carotid artery appeared normal on duplex ultrasonography.
KEYWORDS:
carotid artery; carotidynia; ultrasound
PMID: 2833043
AJNR Am J Neuroradiol. 2017 May 11. doi: 10.3174/ajnr.A5214
TIPIC Syndrome: Beyond the Myth of Carotidynia, a New Distinct Unclassified Entity.
Lecler A1, Obadia M2, Savatovsky J2, Picard H2, Charbonneau F2, Menjot de Champfleur N2, Naggara O2, Carsin B2, Amor-Sahli M2, Cottier JP2, Bensoussan J2, Auffray-Calvier E2, Varoquaux A2, De Gaalon S2, Calazel C2, Nasr N2, Volle G2, Jianu DC2, Gout O2, Bonneville F2, Sadik JC2.
Author information
1
From the Departments of Radiology (A.L., J.S., F.C., J.C.S.), and Neurology (M.O., G.V., O.G.), and Clinical Research Unit (H.P.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Department of Neuroradiology (N.M.d.C.), Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier, France; Department of Radiology (B.C.), Centre Hospitalier Régional Universitaire de Rennes, Rennes, France; Department of Neuroradiology (O.N.), Centre Hospitalier Sainte-Anne, Paris, France; Department of Neuroradiology (M.A.-S.), Pitié-Salpêtrière Hospital, Paris, France; Centre D'imagerie Médicale Tourville (M.A.-S.), Paris, France; Department of Radiology (J.P.C.), Centre Hospitalier Régional Universitaire de Tours, Tours, France; Brain and Imaging Laboratory Unite Mixte de Recherche U930 (J.P.C.), Institut National de la Santé et de la Recherche Médicale, François-Rabelais University, Tours, France; Diagnostic and Interventional Neuroradiology Department (E.A.-C.) and Neurology Department (S.D.G.), Hôpital René et Guillaume-Laënnec, Centre Hospitalier Universitaire de Nantes, Saint-Herblain, France; Department of Radiology (J.B.), Hotel-Dieu Hospital, Paris, France; Department of Radiology (A.V.), Conception Hospital, Aix-Marseille University, Marseille, France; Departments of Neuroradiology (C.C., F.B.) and Neurology (N.N.), Hôpital Pierre-Paul-Riquet, Centre Hospitalier Universitaire Purpan, Toulouse, France; and Department of Neurology (D.C.J.), Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. alecler@for.paris.
2
From the Departments of Radiology (A.L., J.S., F.C., J.C.S.), and Neurology (M.O., G.V., O.G.), and Clinical Research Unit (H.P.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France; Department of Neuroradiology (N.M.d.C.), Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier, France; Department of Radiology (B.C.), Centre Hospitalier Régional Universitaire de Rennes, Rennes, France; Department of Neuroradiology (O.N.), Centre Hospitalier Sainte-Anne, Paris, France; Department of Neuroradiology (M.A.-S.), Pitié-Salpêtrière Hospital, Paris, France; Centre D'imagerie Médicale Tourville (M.A.-S.), Paris, France; Department of Radiology (J.P.C.), Centre Hospitalier Régional Universitaire de Tours, Tours, France; Brain and Imaging Laboratory Unite Mixte de Recherche U930 (J.P.C.), Institut National de la Santé et de la Recherche Médicale, François-Rabelais University, Tours, France; Diagnostic and Interventional Neuroradiology Department (E.A.-C.) and Neurology Department (S.D.G.), Hôpital René et Guillaume-Laënnec, Centre Hospitalier Universitaire de Nantes, Saint-Herblain, France; Department of Radiology (J.B.), Hotel-Dieu Hospital, Paris, France; Department of Radiology (A.V.), Conception Hospital, Aix-Marseille University, Marseille, France; Departments of Neuroradiology (C.C., F.B.) and Neurology (N.N.), Hôpital Pierre-Paul-Riquet, Centre Hospitalier Universitaire Purpan, Toulouse, France; and Department of Neurology (D.C.J.), Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
Abstract
BACKGROUND AND PURPOSE:
The differential diagnosis of acute cervical pain includes nonvascular and vascular causes such as carotid dissection, carotid occlusion, or vasculitis. However, some patients present with unclassified vascular and perivascular changes on imaging previously reported as carotidynia. The aim of our study was to improve the description of this as yet unclassified clinico-radiologic entity.
MATERIALS AND METHODS:
From January 2009 through April 2016, 47 patients from 10 centers presenting with acute neck pain or tenderness and at least 1 cervical image showing unclassified carotid abnormalities were included. We conducted a systematic, retrospective study of their medical charts and diagnostic and follow-up imaging. Two neuroradiologists independently analyzed the blinded image datasets.
RESULTS:
The median patient age was 48 years. All patients presented with acute neck pain, and 8 presented with transient neurologic symptoms. Imaging showed an eccentric pericarotidian infiltration in all patients. An intimal soft plaque was noted in 16 patients, and a mild luminal narrowing was noted in 16 patients. Interreader reproducibility was excellent. All patients had complete pain resolution within a median of 13 days. At 3-month follow-up, imaging showed complete disappearance of vascular abnormalities in 8 patients, and a marked decrease in all others.
CONCLUSIONS:
Our study improved the description of an unclassified, clinico-radiologic entity, which could be described by the proposed acronym: TransIent Perivascular Inflammation of the Carotid artery (TIPIC) syndrome.
© 2017 American Society of Neuroradiology.
PMID: 28495942 DOI: 10.3174/ajnr.A5214
Cleveland Clinic Journal of Medicine.
LEONARD L. LOVSHIN, M.D.
Department of Internal Medicine
Abstract
A YOUNG or middle-aged women reported to her physician because of a sore throat, without fever or other constitutional manifestations, which may have been present for weeks or months. The patient believes that the glands in the neck are swollen. These "swollen glands" are said to act strangely: sometimes the swelling lasts only a few hours, sometimes it persists for weeks; it disappears mysteriously and recurs frequently. During the course of the physical examination the physician finds no abnormality, but when he re-examines the neck and follows the directions given by the patient, he finds a tender swelling that could be an inflamed lymph node.
The patient then is treated with a sulfonamide or with penicillin, and, when no relief ensues, a course of one of the broad-spectrum antibiotics is administered. This therapeutic program also is unsuccessful, and the harried physician begins to think of other possibilities. Since the patient has "swollen glands," feels weak, tired, and run-down, and antimicrobial therapy has not helped, a diagnosis of infectious mononucleosis may be considered. But, results of a heterophil antibody test are negative, and the diagnosis is changed to possible viral infection.
After several weeks or months of having diagnoses changed, the nervous patient can sense that her physician is uncertain, and she begins to worry about the looming possibility of cancer. She keeps poking in the region of the soreness, and the area becomes even more tender. In desperation, further investigations are carried out and nothing definitely abnormal is found. Teeth . . .
Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480
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