A Case Report of Acute Ischemic Stroke Caused by Internal Carotid Artery Dissection Associated with an Overly Long Styloid Process: A Literature ReviewWenxian Lu1*, Wei Zhuang1*, Xuezhen Wang1, Linshan Sun1, Xiaowen Song1#,Bin Li1#1Department of Neurology, Binzhou Medical University Hospital, Binzhou/256603, Shandong, ChinaDeclarations of Interest:NoneDisclosure of Funding:This work was supported by the following grants: Scientific Research Foundation of Binzhou Medical University (grant number BY2020KJ17), National Natural Science Foundation of China (grant number 82201356).*These authors contributed equally to this work.#Correspondence should be addressed to Bin Li (byfylb2017@163.com) and Xiaowen Song (chyna_song1993@163.com).Author ContributionsWenxian Lu : Methodology, Validation, Writing - original draftWei Zhuang : Data curation, Formal analysis, SoftwareXuezhen Wang : Conceptualization, Validation, VisualizationLinshan Sun : Funding acquisitionXiaowen Song : Funding acquisition, Project administration, Writing- review & editingBin Li : Data curation, Methodology, Resources, SupervisionConsentWritten consent was obtained from the patient.Abstract : Elongation of the styloid process is a notable etiological factor in internal carotid artery dissection (ICAD), where the abnormal morphology of the styloid process induces chronic mechanical stress. This stress can precipitate the formation of arterial dissection and, ultimately, ischemic stroke. This report details a case of a patient who developed a left internal carotid artery dissection secondary to styloid process elongation, which was successfully managed. With the continued advancements in medical imaging and an evolving understanding of this pathology, the accurate diagnosis and effective management of such cases are increasingly achievable. Through a comprehensive review of recent domestic and international literature, this article aims to offer valuable diagnostic and therapeutic insights to clinicians, thereby minimizing the risk of misdiagnosis and improving clinical outcomes.Keywords : Styloid process elongation; Ischemic stroke; Internal carotid artery dissection; Styloid syndromeThe styloid process, anatomically situated in close proximity to the cervical vasculature, is positioned between the internal and external carotid arteries, with the internal jugular vein located posteriorly. Anatomical abnormalities of the styloid process may exert mechanical pressure on the cervical vascular structures and nerves, contributing to a spectrum of symptoms known as Styloid Process Syndrome (SPS), or Eagle Syndrome. This syndrome encompasses a variety of clinical manifestations, including foreign body sensation, pharyngeal pain, reflexive ear pain, and head and neck pain [1,2]. Evidence indicates that elongation of the styloid process can lead to transient or permanent ischemic episodes, and is strongly linked to the occurrence of internal carotid artery dissection (ICAD) and vertebral artery dissection (VAD) [1,3]. However, the clinical presentation of stroke associated with Styloid Process Syndrome is often atypical and rare, resulting in limited recognition among clinicians and underscoring the necessity for improved diagnostic and treatment strategies. This article presents a detailed case diagnosed and followed up at the Affiliated Hospital of Binzhou Medical University in 2023, where styloid process elongation precipitated internal carotid artery dissection and ischemic stroke. A comprehensive review of the pertinent literature is provided to offer valuable insights for clinical diagnosis and management.