Min Li1, Xiaogang Gao2, Gary B Rajah3, Jiantao Liang4, Jian Chen4, Feng Yan4, Yuhai Bao4, Liqun Jiao4, Hongqi Zhang4, Yuchuan Ding3, Xunming Ji5, Ran Meng1. 1. Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China. 2. Department of Medicine, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, China. 3. Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan, USA. 4. Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China. 5. Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China; Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China. Electronic address: jixm@ccmu.edu.cn.
Abstract
BACKGROUND: Internal jugular vein stenosis (IJVS) results in poor venous outflow and can result in intracranial hypertension. Venous stenting has become a debated topic for correction of this pathology. CASE DESCRIPTION: A 49-year-old male merchant with bilateral IJVS presented with headache, dizziness, and pulsatile tinnitus. He was found to have intracranial hypertension and left IJVS caused by styloid process compression and right IJVS caused by damage of the venous intima. His symptoms improved after undergoing styloidectomy followed by left intra-internal jugular vein (IJV) balloon. However, 1 year later, the prior symptoms reoccurred. At this time, the patient underwent right intra-IJV stenting. After treatment of the contralateral side, the symptoms resolved during the following 3 months. CONCLUSIONS: The clinical practice in this case indicated that in patients with bilateral IJVS, a 2-side intervention may be necessary when unilateral correction fails. We advise a staged approach to correction of bilateral IJVS. Styloid compression-induced IJVS should be corrected by styloidectomy in combination with balloon and/or stenting, whereas IJVS induced by venous wall issues needs only stenting.
BACKGROUND: Internal jugular vein stenosis (IJVS) results in poor venous outflow and can result in intracranial hypertension. Venous stenting has become a debated topic for correction of this pathology. CASE DESCRIPTION: A 49-year-old male merchant with bilateral IJVS presented with headache, dizziness, and pulsatile tinnitus. He was found to have intracranial hypertension and left IJVS caused by styloid process compression and right IJVS caused by damage of the venous intima. His symptoms improved after undergoing styloidectomy followed by left intra-internal jugular vein (IJV) balloon. However, 1 year later, the prior symptoms reoccurred. At this time, the patient underwent right intra-IJV stenting. After treatment of the contralateral side, the symptoms resolved during the following 3 months. CONCLUSIONS: The clinical practice in this case indicated that in patients with bilateral IJVS, a 2-side intervention may be necessary when unilateral correction fails. We advise a staged approach to correction of bilateral IJVS. Styloid compression-induced IJVS should be corrected by styloidectomy in combination with balloon and/or stenting, whereas IJVS induced by venous wall issues needs only stenting.
Authors: Alba Scerrati; Nicoló Norri; Lorenzo Mongardi; Flavia Dones; Luca Ricciardi; Gianluca Trevisi; Erica Menegatti; Paolo Zamboni; Michele Alessandro Cavallo; Pasquale De Bonis Journal: Ann Transl Med Date: 2021-04
Authors: Anirudh Arun; Matthew R Amans; Nicholas Higgins; Waleed Brinjikji; Mithun Sattur; Sudhakar R Satti; Peter Nakaji; Mark Luciano; Thierry Agm Huisman; Abhay Moghekar; Vitor M Pereira; Ran Meng; Kyle Fargen; Ferdinand K Hui Journal: Neuroradiol J Date: 2021-07-05