A Case Report on Symptomatic Internal Jugular Venous Compression: Clinical and Radiographic Improvement with Bilateral C1 Tubercle Resection

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Paolo A. Bolognese, MD Michael T. Caton, MD Ilene S. Ruhoy, MD, PhD Sophie Bloom Jaclyn N. Amaru John B. Biggins, MS, PA-C Navdeep S. Nayyar, MD, MBA


This case report examines internal jugular venous compression necessitating surgical intervention. The focal point is a 48-year-old female patient with Ehlers-Danlos syndrome, who developed intracranial hypertension due to bilateral compression of the internal jugular veins. The patient's symptomatic presentation, marked by persistent pain and pressure localized to retroorbital and occipital regions, accentuated during orthostatic conditions, propelled the investigation that culminated in a comprehensive evaluation via cranial and cervical computed tomography. 

The diagnostic revelation of bilateral compression of the internal jugular veins, primarily attributed to C1 tubercles, prompted an elective surgical intervention in March 2023. The meticulous procedure involved bilateral resection of the C1 tubercles, with subsequent postoperative assessments revealing a notable reduction in intracranial pressure. The immediate intraoperative augmentation in the caliber of the jugular vein post-decompression was corroborated through bilateral computed tomographic venography. 

In the broader context of neurosurgical interventions for internal jugular venous compression, this case underscores the promising technique of C1 lateral mass resection for alleviating intracranial hypertension, with potential variations based on the clinical significance ascribed to C1 tubercles and the styloid process. The findings presented in this report contribute to the evolving body of evidence supporting surgical approaches in effectively managing internal jugular venous compression and associated intracranial hypertension, thereby enhancing the understanding and treatment of this challenging condition.

Keywords: Ehlers-Danlos Syndrome, Internal Jugular Vein Compression, Intracranial Hypertension, C1 Tubercles

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How to Cite
BOLOGNESE, Paolo A. et al. A Case Report on Symptomatic Internal Jugular Venous Compression: Clinical and Radiographic Improvement with Bilateral C1 Tubercle Resection. Medical Research Archives, [S.l.], v. 12, n. 5, may 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5415>. Date accessed: 19 june 2024. doi: https://doi.org/10.18103/mra.v12i5.5415.
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