Retrospective Investigation Of The Relationship Between The Stylohyoid Ligament And Carotid Dissection

Author(s): Halil Ibrahim Ozdemir, Celal Cinar & Murat Koylu

Purpose : Carotid dissection is the most important cause of ischemic stroke in young adults. Ischemic stroke rate up to 20% in people under 50 years. Recently, young patients under 50 years of age who were admitted to the emergency department with ischemic stroke complaints were diagnosed with carotid dissection.

Methods : For this purpose, cranio-cervical CT angio images of patients admitted to our clinic with suspected carotid artery dissection and diagnosed as ICA dissection were retrospectively reviewed. the characteristics of the patients with ICA dissection and normal patients undergoing cranio-cervical CT angiography were investigated using 3D anatomical programs, specifically the course of the stylohyoid ligament, the distance between stylohyoid ligament and the carotid artery, and contact between stylohyoid ligament and the carotid artery. Sectra and AW Server 2 archives and XIO 4.80 radiotherapy planning programs were used for 3D analysis of the images. The data obtained from the analyzes were evaluated using the SPSS statistical program.

Results :  Descriptive statistics, Independent Samples T-Test, Pearson correlation analysis, multiple regression analysis, and graphical programs were used in statistical evaluations. According to Independent Samples T-Test results performed under SPSS, the distance between the ICA with stylohyoid ligament at 0.05 (sig.2-tailed) level (t = 5,950, sig = 0,000) and the difference between the age of the patients (t = 2,226, sig = 0,026) was significant. In addition, the axial (t = 2,938, sig = 0,005) and sagittal (t = 2,307, sig = 0,026) angles between the genders were different. In Pearson correlation analysis, styloid axial angles (r = -0.316, sig = 0.029), styloid sagittal angles (r = -0.333, sig = 0.020) and age of ICA dissection (r = -0.332, sig = 0.026) at 0,05 (2-tailed) level was found to be correlated. More importantly, in patients with ICA dissection, it was found that there was a strong correlation between stylohyoid ligament-carotid distance (r = -0.659, sig = 0.000) at the 0.01 (2-tailed) level.

Conclusion : As a result, the closure of the stylohyoid ligament closer than 3.9 mm to the carotid for any reason increases the risk of dissection in young patients. It is thought that the results of this research will constitute a step for radiological artificial intelligence studies.