Carotidynia: Nonsteroidal Anti-inflammatory Drug Treatment Resulting in Symptom Resolution Within Weeks

Carotidynia, also known as Fay syndrome, is a rare vascular disorder characterized by continuous or intermittent lateral cervical pain in the region of the carotid artery bifurcation. It can be associated with various vascular and non-vascular processes and typically includes the presence of periadventitial thickening, with preservation of the lumen and without causing hemodynamic alterations. We present a case of a 45-year-old woman who was referred for an internal medicine consultation due to the presence of a foreign body sensation in the right cervical region. A CT scan of this area revealed unilateral perivascular thickening of the right internal carotid artery. A benign course of naproxen, a nonsteroidal anti-inflammatory drug (NSAID), was initiated, resulting in symptom improvement. Three months later, a follow-up CT angiography for vascular monitoring was performed, which showed significant improvement in the thickening around the right internal carotid artery. Carotidynia has been found to respond effectively to NSAIDs or corticosteroids, with resolution typically occurring within weeks following treatment. However, it is important to note that recurrences are possible, especially due to poor adherence to treatment.