Successful treatment of cold-induced neck pain and jaw claudication with revascularization of severe atherosclerotic external carotid artery stenoses.

PURPOSE: To present a patient whose cold-triggered neck pain and jaw claudication remitted after revascularization of severe atherosclerotic stenoses of both external carotid arteries (ECA). CASE REPORT: A 60-year-old vintner presented with jaw claudication and neck pain that increased in severity while he worked in cold temperatures. Angiography showed severe atherosclerotic narrowing of both ECAs. The symptoms disappeared after staged, bilateral percutaneous transluminal angioplasty procedures. However, the pain recurred together with severe bilateral ECA restenoses 6 months later; once again, the pain remitted after redilation. Right-sided neck pain and severe ECA narrowing recurred 5 months later and resolved after carotid endarterectomy. The patient remained asymptomatic and showed no ECA stenosis during a 3-year follow-up.
CONCLUSION: Cold-triggered neck pain may be a symptom of atherosclerotic ECA stenoses, and carotid revascularization may be an efficient and safe treatment.