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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 26:201-202, January 2005
© 2005 American Society of Neuroradiology

Letter

Ultrasonography of Carotidynia

Christian Arning^a

^a Department of Neurology
AK Wandsbek
Hamburg, Germany

Carotidynia is an unilateral neck pain syndrome associated with tenderness to palpitation over the carotid bifurcation, first described by Fay in 1927 (1). We performed ultrasonographic (US) investigation in six consecutive cases that fulfilled clinical criteria of idiopathic carotidynia according to the former International Headache Society classification (2). In all patients, hypoechoic wall thickening of the carotid bulb was found exactly in the region of tenderness, leading to a mild lumen narrowing and a large outward extension of the vessel wall. In some cases, the wall thickening was found in two different layers of the vessel wall (Fig 1A). Follow-up US 3–5 weeks later showed significantly fewer pathologic findings (Fig 1B). In two patients, MR imaging of the carotid bifurcation showed no evidence of intramural hematoma. The findings correspond to recently published MR imaging data that described abnormally enhancing tissue surrounding the symptomatic carotid artery in five cases of carotidynia (3); in one of these patients, MR imaging was repeated after resolution of symptoms and showed normal findings (3). In a recently published case of carotidynia, histologic findings of inflammation of the carotid adventitia were presented (4); however, the cause of the inflammatory process remained obscure.

View larger version (60K): [in this window] [in a new window]   FIG 1. US findings in a case of carotidynia. CCA, common carotid artery. ICA, internal carotid artery. A, Initial findings of wall thickening, leading to a mild lumen narrowing and a major outward extension of the vessel. B, Follow-up findings 4 weeks later show significantly fewer pathologic findings.

Our findings of a similar US pattern in six patients suggest that idiopathic carotidynia is a distinct entity, possibly caused by inflammation.

References

1. Fay T. Atypical neuralgia. Arch Neurol Psychiatry 1927;18:309–315

2. Headache Classification Committee of the International Headache Society. Classification and diagnosis criteria for headache disorders, cranial neuralgias, and facial pain [Suppl]. Cephalgia 1988;8:48–49

3. Burton BS, Syms MJ, Petermann GW, Burgess LPA. MR imaging of patients with carotidynia. AJNR Am J Neuroradiol 2000;21:766–769[Abstract/Free Full Text]

4. Upton PD, Smith JG, Charnock DR. Histologic confirmation of carotidynia. Otolaryngol Head Neck Surg 2003;129:443–444[Medline]

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This Article Figures Only Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Arning, C. Search for Related Content PubMed PubMed Citation Articles by Arning, C.