2021 Volume 43 Issue 5 Pages 457-461
We describe a rare case of 81-year-old woman who presented repetitive ischemic stroke due to the mechanical stimulation of the hyoid bone. The patient suffered from embolic strokes three times in a year. Although she had several examinations to detect embolic source, a definite embolic source was not detected. Magnetic resonance angiography showed only low-grade internal carotid artery stenosis, but three-dimensional computed tomographic angiography proved clearly the entrapment of the top of common carotid artery due to hyoid bone. We diagnosed embolic stroke due to the mechanical stimulation of the hyoid bone, and the patient underwent carotid endarterectomy. The anatomical position of hyoid bone may be variable and more than expected, and it can be a risk factor for embolic stroke even if low-grade carotid artery stenosis. We should examine carefully the relationship between the carotid artery and the surrounding bone structures in the cases of embolic stroke of undetermined source.
