Idiopathic carotidynia

Case contributed by Dirk Sehr


Acute cervical pain. No history of trauma. No neurological findings.

Patient Data

Age: 35 years old
Gender: Female

Hypoechoic thickening of the vascular wall at the junction of the internal carotid artery affecting several wall layers. Best seen in B-image setting, no hemodynamic signs of stenosis

Case Discussion

Idiopathic carotidynia is an atypical neuralgia in the neck, typically localized at the carotid bifurcation. Patients typically report pain for a few days without a traumatic history.

This idiopathic neck pain syndrome as classified by the International Headache Society in 1988, and is typically associated with tenderness over the carotid bifurcation without vessel wall abnormality or significant stenosis 1.

Histological studies demonstrate the presence of non-specific inflammatory changes including vascular and fibroblast proliferation with low-grade chronic active inflammation in the vessel wall 2.

Following corticosteroids the symptoms and wall thickening should resolve.

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