{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T03:12:17Z","timestamp":1779333137327,"version":"3.51.4"},"reference-count":4,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003790","name":"Hiroshima University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003790","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurol Belg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>A 62-year-old woman presented with sudden left hemiparesis. Magnetic resonance imaging (MRI) revealed scattered acute infarctions in the right middle cerebral artery territory. MR angiography (MRA) revealed no significant stenosis in the major intracranial or extracranial arteries, but a filling defect was noted at the origin of the right internal carotid artery (ICA). On day 5, MRA demonstrated a change in the positional relationship between the ICA and the external carotid artery. Although carotid ultrasonography initially revealed the ICA was located behind the hyoid bone, making plaque identification unclear, the ICA shifted laterally along the hyoid bone during swallowing, enabling visualization of a plaque. The flip-flop phenomenon, caused by dynamic compression of the ICA by the hyoid bone during swallowing, is a possible source of embolic stroke. When the ICA lies behind the hyoid bone, dynamic assessment and careful plaque evaluation are essential.<\/jats:p>","DOI":"10.1007\/s13760-026-03090-0","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T02:54:39Z","timestamp":1779332079000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Internal carotid arteries behind the hyoid bone as a clue for identifying the flip-flop phenomenon"],"prefix":"10.1007","author":[{"given":"Ayaka","family":"Kishi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohisa","family":"Nezu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiro","family":"Aoki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Yamazaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirofumi","family":"Maruyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"3090_CR1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004492","author":"N Kinoshita","year":"2017","unstructured":"Kinoshita N, Saito K, Tanaka T, Kajimoto K, Yamagami H, Morita Y, Ihara M, Nagatsuka K (2017) Swallowing-induced displacement of the carotid artery as a risk of stroke: Flip-flop phenomenon. Neurology. https:\/\/doi.org\/10.1212\/WNL.0000000000004492","journal-title":"Neurology"},{"key":"3090_CR2","doi-asserted-by":"publisher","DOI":"10.1159\/000490180","author":"N Kinoshita","year":"2018","unstructured":"Kinoshita N, Saito K, Yamaguchi Y, Abe S, Wada S, Tanaka T, Kajimoto K, Yamagami H, Maruyama H, Toyoda K, Ihara M, Nagatsuka K (2018) Flip-Flop Phenomenon: Swallowing-Induced Arterial Displacement as an Indicator of Carotid Artery Disease. Cerebrovasc Dis. https:\/\/doi.org\/10.1159\/000490180","journal-title":"Cerebrovasc Dis."},{"key":"3090_CR3","doi-asserted-by":"publisher","DOI":"10.1016\/j.radcr.2025.06.078","author":"N El Yaagoubi","year":"2025","unstructured":"El Yaagoubi N, Sadki W, Chtaou N, El Midaoui A, Bouchal S, Lamrani Y, Oudidi A, Maaroufi M, Faouzi Belahsen M (2025) An unusual case of ischemic stroke resulting from hyoid bone compression of the internal carotid artery. Radiol Case Rep. https:\/\/doi.org\/10.1016\/j.radcr.2025.06.078","journal-title":"Radiol Case Rep"},{"key":"3090_CR4","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2024.5028","author":"F Bouille","year":"2025","unstructured":"Bouille F, De Malherbe M, Pico F (2025) Ischemic Stroke Due to Compression of a Wandering Internal Carotid Artery by the Hyoid Bone. JAMA Neurol. https:\/\/doi.org\/10.1001\/jamaneurol.2024.5028","journal-title":"JAMA Neurol"}],"container-title":["Acta Neurologica Belgica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13760-026-03090-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s13760-026-03090-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13760-026-03090-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T02:54:41Z","timestamp":1779332081000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s13760-026-03090-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,21]]},"references-count":4,"alternative-id":["3090"],"URL":"https:\/\/doi.org\/10.1007\/s13760-026-03090-0","relation":{},"ISSN":["0300-9009","2240-2993"],"issn-type":[{"value":"0300-9009","type":"print"},{"value":"2240-2993","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,21]]},"assertion":[{"value":"23 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}