A Lecler1, M Obadia2, J Savatovsky3, H Picard4, F Charbonneau3, N Menjot de Champfleur5, O Naggara6, B Carsin7, M Amor-Sahli8,9, J P Cottier10,11, J Bensoussan12, E Auffray-Calvier13, A Varoquaux14, S De Gaalon15, C Calazel16, N Nasr17, G Volle2, D C Jianu18, O Gout2, F Bonneville16, J C Sadik3. 1. From the Departments of Radiology (A.L., J.S., F.C., J.C.S.) alecler@for.paris. 2. Neurology (M.O., G.V., O.G.). 3. From the Departments of Radiology (A.L., J.S., F.C., J.C.S.). 4. Clinical Research Unit (H.P.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France. 5. Department of Neuroradiology (N.M.d.C.), Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier, France. 6. Department of Neuroradiology (O.N.), Centre Hospitalier Sainte-Anne, Paris, France. 7. Department of Radiology (B.C.), Centre Hospitalier Régional Universitaire de Rennes, Rennes, France. 8. Department of Neuroradiology (M.A.-S.), Pitié-Salpêtrière Hospital, Paris, France. 9. Centre D'imagerie Médicale Tourville (M.A.-S.), Paris, France. 10. Department of Radiology (J.P.C.), Centre Hospitalier Régional Universitaire de Tours, Tours, France. 11. Brain and Imaging Laboratory Unite Mixte de Recherche U930 (J.P.C.), Institut National de la Santé et de la Recherche Médicale, François-Rabelais University, Tours, France. 12. Department of Radiology (J.B.), Hotel-Dieu Hospital, Paris, France. 13. Diagnostic and Interventional Neuroradiology Department (E.A.-C.). 14. Department of Radiology (A.V.), Conception Hospital, Aix-Marseille University, Marseille, France. 15. Neurology Department (S.D.G.), Hôpital René et Guillaume-Laënnec, Centre Hospitalier Universitaire de Nantes, Saint-Herblain, France. 16. Departments of Neuroradiology (C.C., F.B.). 17. Neurology (N.N.), Hôpital Pierre-Paul-Riquet, Centre Hospitalier Universitaire Purpan, Toulouse, France. 18. Department of Neurology (D.C.J.), Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
Abstract
BACKGROUND AND PURPOSE: The differential diagnosis of acute cervical pain includes nonvascular and vascular causes such as carotid dissection, carotid occlusion, or vasculitis. However, some patients present with unclassified vascular and perivascular changes on imaging previously reported as carotidynia. The aim of our study was to improve the description of this as yet unclassified clinico-radiologic entity. MATERIALS AND METHODS: From January 2009 through April 2016, 47 patients from 10 centers presenting with acute neck pain or tenderness and at least 1 cervical image showing unclassified carotid abnormalities were included. We conducted a systematic, retrospective study of their medical charts and diagnostic and follow-up imaging. Two neuroradiologists independently analyzed the blinded image datasets. RESULTS: The median patient age was 48 years. All patients presented with acute neck pain, and 8 presented with transient neurologic symptoms. Imaging showed an eccentric pericarotidian infiltration in all patients. An intimal soft plaque was noted in 16 patients, and a mild luminal narrowing was noted in 16 patients. Interreader reproducibility was excellent. All patients had complete pain resolution within a median of 13 days. At 3-month follow-up, imaging showed complete disappearance of vascular abnormalities in 8 patients, and a marked decrease in all others. CONCLUSIONS: Our study improved the description of an unclassified, clinico-radiologic entity, which could be described by the proposed acronym: TransIent Perivascular Inflammation of the Carotid artery (TIPIC) syndrome.
BACKGROUND AND PURPOSE: The differential diagnosis of acute cervical pain includes nonvascular and vascular causes such as carotid dissection, carotid occlusion, or vasculitis. However, some patients present with unclassified vascular and perivascular changes on imaging previously reported as carotidynia. The aim of our study was to improve the description of this as yet unclassified clinico-radiologic entity. MATERIALS AND METHODS: From January 2009 through April 2016, 47 patients from 10 centers presenting with acute neck pain or tenderness and at least 1 cervical image showing unclassified carotid abnormalities were included. We conducted a systematic, retrospective study of their medical charts and diagnostic and follow-up imaging. Two neuroradiologists independently analyzed the blinded image datasets. RESULTS: The median patient age was 48 years. All patients presented with acute neck pain, and 8 presented with transient neurologic symptoms. Imaging showed an eccentric pericarotidian infiltration in all patients. An intimal soft plaque was noted in 16 patients, and a mild luminal narrowing was noted in 16 patients. Interreader reproducibility was excellent. All patients had complete pain resolution within a median of 13 days. At 3-month follow-up, imaging showed complete disappearance of vascular abnormalities in 8 patients, and a marked decrease in all others. CONCLUSIONS: Our study improved the description of an unclassified, clinico-radiologic entity, which could be described by the proposed acronym: TransIent Perivascular Inflammation of the Carotid artery (TIPIC) syndrome.
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