LAUSR

BACKGROUND Eagle syndrome with stroke onset is a rare condition. Carotid stenting of dissected arteries and/or surgical resection of the elongated styloid process (SP) are frequently performed; however, there are no definitive criteria for selecting these treatments. CASE DESCRIPTION A 46-year-old man presented with left hemiplegia. He was diagnosed with acute infarction in the right frontal and parietal lobes and bilateral internal carotid artery (ICA) dissection due to the elongated SP, via magnetic resonance imaging and computed tomography angiography. He was treated with stenting of the left ICA dissection, while the right ICA dissection was observed. However, the right ICA dissection deteriorated four days after the initial event, and additional stenting was implemented. He underwent bilateral prophylactic styloidectomy with an extra-oral approach eight months after symptom onset. More than three years after the styloidectomy, he has not experienced recurrence of the infarction. CONCLUSION Stenting in the acute phase prevented the recurrence of stroke, and SP resection in the chronic phase cured vascular Eagle syndrome. This staged therapy could be beneficial in the treatment of vascular Eagle syndrome.