Reduced stylocarotid distance is associated with carotid artery dissection
Alexander Brose, Sophie Lehmann, Sabine Sari, Omar Alhaj Omar, Tobias Braun, Martin B. Juenemann, Tobias Struffert, Heidrun H. Kraemer, Anne MrochenAbstract:
BACKGROUND:
Cervical artery dissection is a major cause of ischemic stroke in young adults, but its etiology often remains unclear in the absence of connective-tissue disease. Variation in styloid process (SP) anatomy and its proximity to the internal carotid artery (ICA) may contribute mechanically to arterial injury, but its role in ICA dissection is not well defined.
METHODS:
We conducted a retrospective, single-center observational study using a continuously maintained computed tomography angiography registry. Patients with spontaneous ICA dissection were identified and matched 1:2 by age and sex to control subjects without cervical vascular abnormalities. Quantitative computed tomography measurements of the stylohyoid complex morphology and stylocarotid distance were obtained using oblique multiplanar reconstructions.
RESULTS:
The analysis included 44 measurements from patients with ICA dissection and 88 matched control measurements. Among patients with ICA dissection, the distance between the stylohyoid complex and the ICA on the affected side was smaller than on the contralateral side (median: 3.3 mm [interquartile range (IQR): 2.08–5.15] vs. 4.7 mm [IQR: 3.08–7.05];
CONCLUSION:
Close spatial proximity between the stylohyoid complex and the ICA represents an anatomical susceptibility factor for ICA dissection. Recognizing this relationship may improve individualized risk stratification and inform tailored imaging follow-up, while underscoring the need for prospective studies to clarify its implications for long-term management.