CASE REPORT article
Front. Cardiovasc. Med.
Sec. Cardioneurology
Unveiling Segmental Hemodynamic Heterogeneity in Internal Jugular Vein Stenosis: A Patient-Specific CFD Analysis
Hui Li 1
Jian Dong 2
Chunxiao Lu 3
Xiao Xue 4
Lu Liu 3
Weiyue Zhang 5
Yifan Zhou 6
Huimin Jiang 6
Yali Wu 7
Beibei Mao 7
Guangtong Zhu 7
Haiyang Ma 7
Jian Chen 8
Zhiqiang Hu 7
Chen Zhou 3
Xunming JI 3
1. Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
2. Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing, China
3. Xuanwu Hospital Capital Medical University Department of Neurology, Beijing, China
4. Ophthalmology Department, Xuanwu Hospital, Beijing, China
5. Beihang University, Beijing, China
6. Capital Medical University, Beijing, China
7. Beijing Shijitan Hospital Capital Medical University, Beijing, China
8. Xuanwu Hospital Department of Neurosurgery, Beijing, China
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Abstract
Background and Purpose: While non-thrombotic internal jugular vein stenosis (IJVS), predominantly from extrinsic compression, is increasingly linked to cerebral venous outflow insufficiency, its segment-specific pathophysiology remains unclear. Given the distinct J1-J3 anatomy of the internal jugular vein (IJV), segment-based characterization may aid management. Case Presentation: We retrospectively analyzed five patients with non-thrombotic IJVS affecting different segments and etiologies. Clinical features, segment involvement, and lesion morphology were recorded. Patient-specific hemodynamics were modeled with computational fluid dynamics (CFD) from head-neck CT venography (CTV) using identical boundary conditions for cross-case comparison. All cases showed trans-stenotic pressure gradients that increased with stenosis severity. Elevated wall shear stress localized to the stenosis, with high-velocity jets within the narrowed segment and downstream vortices in post-stenotic regions. J3 stenoses from C1 transverse process and/or styloid compression improved after decompression, with better hemodynamic metrics, venous morphology, and symptoms. J1-J2 stenoses were mainly due to soft-tissue or arterial compression; feasible interventions were limited and conservative care yielded modest benefit. Conclusions: IJVS demonstrates segment-specific morphological and hemodynamic patterns. Patient-specific CFD derived from CTV quantitatively characterizes these abnormalities and may inform treatment selection and prognosis, although validation in larger cohorts is warranted.
Summary
Keywords
Internal jugular vein stenosis, Cerebral venous outflow insufficiency, Internal Jugular veindecompression, Extrinsic venous compression, Segmental venous stenosis
Received
08 August 2025
Accepted
25 November 2025
Copyright
© 2025 Li, Dong, Lu, Xue, Liu, Zhang, Zhou, Jiang, Wu, Mao, Zhu, Ma, Chen, Hu, Zhou and JI. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Xunming JI
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