Delayed Cortical Hyperperfusion Induced by Positional Carotid Compression in Stylocarotid Syndrome: A Case Report
Abstract
Cortical hyperperfusion is commonly discussed in the context of cerebral hyperperfusion syndrome after carotid revascularization; however, hyperperfusion-related cortical injury may also occur after transient ischemia. A 76-year-old man developed a recurrent impaired consciousness and left hemiparesis 18 days after cervical laminoplasty. Although the initial imaging was normal, delayed cortical diffusion abnormalities with concordant hyperperfusion on arterial spin labeling emerged despite preserved arterial patency. Computed tomography revealed a markedly elongated right styloid process (78 mm) that caused positional compression of the internal carotid artery during neck flexion. Embolic and epileptic mechanisms were considered unlikely. Blood pressure control was followed by radiological and clinical improvements. This case suggests that stylocarotid syndrome may be a potential trigger for hyperperfusion-related cortical injury.
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BibTeX
@article{yanagida2026delayed,
title = {{Delayed Cortical Hyperperfusion Induced by Positional Carotid Compression in Stylocarotid Syndrome: A Case Report}},
author = {Ren Yanagida and Tatsuya Ueno and Ko Hiyama and Maki Miura and Iku Kinoshita and Rie Haga and Akira Arai},
journal = {Internal Medicine},
year = {2026},
month = sep,
doi = {10.2169/internalmedicine.7448-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7448-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Delayed Cortical Hyperperfusion Induced by Positional Carotid Compression in Stylocarotid Syndrome: A Case Report
AU - Ren Yanagida
AU - Tatsuya Ueno
AU - Ko Hiyama
AU - Maki Miura
AU - Iku Kinoshita
AU - Rie Haga
AU - Akira Arai
PY - 2026
DA - 2026/09/08
JO - Internal Medicine
DO - 10.2169/internalmedicine.7448-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7448-26/_article
AB - Cortical hyperperfusion is commonly discussed in the context of cerebral hyperperfusion syndrome after carotid revascularization; however, hyperperfusion-related cortical injury may also occur after transient ischemia. A 76-year-old man developed a recurrent impaired consciousness and left hemiparesis 18 days after cervical laminoplasty. Although the initial imaging was normal, delayed cortical diffusion abnormalities with concordant hyperperfusion on arterial spin labeling emerged despite preserved arterial patency. Computed tomography revealed a markedly elongated right styloid process (78 mm) that caused positional compression of the internal carotid artery during neck flexion. Embolic and epileptic mechanisms were considered unlikely. Blood pressure control was followed by radiological and clinical improvements. This case suggests that stylocarotid syndrome may be a potential trigger for hyperperfusion-related cortical injury.
SN - 1349-7235
SN - 0918-2918
ER -