CT angiography with 3-D rendering showing large left styloid process completely calcified right stylohyoid ligament

CT angiography with three-dimensional rendering showing a large left styloid process (black arrow) and a large completely calcified right stylohyoid ligament (blue arrow). A 30-year-old man presented to the emergency department with a several-day history of intermittent neck pain, dysarthria, right facial droop and paresthesias, and right arm weakness. Non-contrast CT of the head showed no evidence of hemorrhage, mass lesion, or acute infarction. CT angiography of the head and neck with three-dimensional rendering demonstrated a large left styloid process and partially calcified stylohyoid ligament and large completely calcified right stylohyoid ligament consistent with Eagle syndrome. The left cervical internal carotid artery had severe focal dissection and 99% narrowing. The right cervical internal carotid artery had mild narrowing and intimal irregularity consistent with carotid dissection. Magnetic resonance imaging of the brain demonstrated scattered infarcts in a band-like pattern within the deep white matter of the left frontal lobe. He declined surgical management. (Source: Bremmer E, Sergent S, Ashurst J. Eagle syndrome. Clin Pract Cases Emerg Med 2018;2(4):359-60. Creative Commons Attribution license [CC BY 4.0]. http://creativecommons.org/licenses/by/4.0.)