Cervical spondylotic internal jugular venous compression syndrome

Abstract

Aims This study aimed to identify the clinical profiles of cervical spondylosis‐related internal jugular vein stenosis (IJVS) comprehensively. Methods A total of 46 patients, who were diagnosed as IJVS induced by cervical spondylotic compression were recruited. The clinical manifestations and imaging features of IJVS were presented particularly in this study. Results Vascular stenosis was present in 69 out of the 92 internal jugular veins, in which, 50.7% (35/69) of the stenotic vessels were compressed by the transverse process of C1, and 44.9% (31/69) by the transverse process of C1 combined with the styloid process. The transverse process of C1 compression was more common in unilateral IJVS (69.6% vs 41.3%, P = 0.027) while the transverse process of C1 combined with the styloid process compression had a higher propensity to occur in bilateral IJVS (52.2% vs 30.4%, P = 0.087). A representative case underwent the resection of the elongated left lateral mass of C1 and styloid process. His symptoms were ameliorated obviously at 6‐month follow‐up. Conclusions This study proposes cervical spondylotic internal jugular venous compression syndrome as a brand‐new cervical spondylotic subtype. A better understanding of this disease entity can be of great relevance to clinicians in making a proper diagnosis.

Dynamic Internal Jugular Vein Compression by Hypertrophic Hyoid Bone: Management and Outcomes

“…Anatomic impingement of the upper IJV, when present, is most commonly observed between the digastric muscle and an adjacent cervical transverse process. Reports of symptomatic osseous impingement of the extracranial IJV in the literature are mostly composed of styloidogenic jugular venous compression syndrome (SJVCS) [2][3][4][5][6]. Osseous compression by a hypertrophic hyoid bone, to our knowledge, has not been observed before in the literature.…”

“…The clinical manifestations of IJV compression are insidious and frequently heterogeneous. The current understanding and body of literature on this topic is limited to isolated case reports and small clinical series [1][2][3][4][5][6]. We describe a patient with new onset of atypical, ill-defined facial pain, resolving with decompression of the extracranial IJV by a hypertrophic hyoid bone.…”

Clinical Classification and Collateral Circulation in Chronic Cerebrospinal Venous Insufficiency

“…The diagnosis criteria of extraluminal compression induced IJVS included: (a) the residual cross-sectional area <50% of the estimated cross-sectional area at stenosis segment; and (b) with abnormally dilated paraspinal collateral veins (19,20) ( Figures 1A-D).…”

“…The definitions for the expansion degree of external and internal vertebral veins were as follows: severe external vertebral venous expansion was the maximal cross-sectional area of the external vertebral vein ≥25% of the estimated cross-sectional area at the stenosis segment or the normal cross-sectional area at J3 of the adjacent IJV, and mild external vertebral venous expansion was <25%. Severe internal vertebral venous expansion was the length of the internal vertebral vein ≥50% of the length of the adjacent IJV with mass expansion at the atlantoaxial vertebra, and mild internal vertebral venous expansion was <50% (19,20) ( Figures 1L-O).…”

“…Standard and individualized therapy was administered according to the etiology of each patient, including anticoagulant/ antiplatelet treatment, oxygen inhalation, dehydration, and other symptomatic therapy to relieve non-specific symptoms. Given lack of a universal indication and consensus on treatment strategy, the interventional and surgical therapies were applied only when a significant obstruction of IJV was confirmed and the patient strongly requested an active surgical intervention, after adequate preoperative preparation (9,20).…”