Understanding jugular venous outflow disturbance

Abstract

Extracranial venous abnormalities, especially jugular venous outflow disturbance, were originally viewed as nonpathological phenomena due to a lack of realization and exploration of their feature and clinical significance. The etiology and pathogenesis are still unclear, whereas a couple of causal factors have been conjectured. The clinical presentation of this condition is highly variable, ranging from insidious to symptomatic, such as headaches, dizziness, pulsatile tinnitus, visual impairment, sleep disturbance, and neck discomfort or pain. Standard diagnostic criteria are not available, and current diagnosis largely depends on a combinatory use of imaging modalities. Although few researches have been conducted to gain evidence-based therapeutic approach, several recent advances indicate that intravenous angioplasty in combination with stenting implantation may be a safe and efficient way to restore normal blood circulation, alleviate the discomfort symptoms, and enhance patients' quality of life. In addition, surgical removal of structures that constrain the internal jugular vein may serve as an alternative or adjunctive management when endovascular intervention is not feasible. Notably, discussion on every aspect of this newly recognized disease entity is in the infant stage and efforts with more rigorous designed, randomized controlled studies in attempt to identify the pathophysiology, diagnostic criteria, and effective approaches to its treatment will provide a profound insight into this issue.

Cervical spondylotic internal jugular venous compression syndrome

“…Other extrinsic or nonextrinsic stenoses were excluded from this study as well. Risk factors for nonextrinsic stenoses have not been determined currently, whereas, our clinical practice implies that certain systemic disorders, such as autoimmunity diseases, hypertension and diabetes may be associated with venous wall anomalies of the IJV . Consequently, a total of 46 patients were involved.…”

“…All patients received standard medical therapy, including antiplatelets/anticoagulation, dehydration, and other symptomatic treatment to prevent against venous thrombosis, decrease intracranial hypertension, and relieve afflicted symptoms . As there is no consensus over the surgical intervention for such osseous impingement, only patients who strongly requested surgery were performed with cervical lateral mass resection and subsequent stenting/balloon dilatation.…”

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

“…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.…”

“…Successful treatment of IJV osseous impingement is dependent on accurate diagnosis and adequate treatment [1]. Head and neck CTV with 3D reconstruction can effectively demonstrate the extrinsic osseous foci of IJV stenosis.…”

“…Disturbances in extracranial internal jugular vein (IJV) outflow are increasingly being recognized as a cause of various clinical conditions such as idiopathic intracranial hypertension (IIH). While the clinical sequelae of disrupted arterial flow present with a predictable pattern, symptoms related to disruption of venous outflow are highly variable and difficult to diagnose early [1]. We present a case of dynamic unilateral IJV compression presenting with atypical facial and neck pain.…”