Case Report: Transient perivascular inflammation of the carotid artery syndrome: a rare etiology of self-limiting carotidynia.

Objectives: Transient perivascular inflammation of the carotid artery (TIPIC) syndrome is a recently recognized clinicoradiological entity that has not yet been formally incorporated into established disease classifications. It is frequently overlooked in clinical practice because of its unclear etiology and nonspecific symptoms. This study aimed to provide a comprehensive summary of the existing literature to improve clinical awareness and diagnostic accuracy. Methods: A retrospective analysis of literature on TIPIC syndrome published before May 2024 was performed, while we reported a case of TIPIC syndrome. The results of both were collated and discussed. Results: A total of 58 reports including 137 patients with TIPIC were identified. The median age of the patients was 48 years, with a female predominance. All patients presented with neck pain or other concomitant symptoms, mostly with unilateral involvement. All patients had a characteristic imaging presentation with eccentric inflammatory infiltrates in the vessel wall and surrounding tissues. About 1/3 of the patients had luminal stenosis but no blood flow disturbances. The median time to resolution of neck pain symptoms in patients was 2 weeks. Both clinical symptoms and imaging abnormalities may resolve spontaneously or following pharmacological treatment. Conclusions: TIPIC syndrome appears to be a self-limiting condition that may involve transient immune-mediated mechanisms. Clinical awareness of this disease is needed to prevent missed diagnosis or misdiagnosis. The role of imaging in differential diagnosis and follow-up should be appreciated. There are still many unknowns in TIPIC syndrome and a large number of clinical studies are needed to fill these gaps.