CASE REPORT article
Front. Surg.
Sec. Neurosurgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1639108
Isolated Surgical Decompression for Compressive Internal Jugular Vein Stenosis: : Case Series and Literature Review
Provisionally accepted
- Beijing Shijitan Hospital, Capital Medical University, Beijing, China
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Background: Internal jugular vein stenosis (IJVS) is an underrecognized cause of cerebral venous outflow obstruction, commonly presenting with nonspecific symptoms such as head-noise, tinnitus, dizziness, headaches, and visual or auditory disturbances. Extrinsic compression by bony structures, particularly transverse process of the atlas (C1), has emerged as a significant but frequently ignored etiology. This study presents the first case series demonstrating that isolated resection of the C1 transverse process can restore venous outflow and provide durable relief of head-noise–dominant symptoms. Objective: This study presents three cases of symptomatic IJVS caused by bony compression, marked by head noise – dominant presentation and failure of conservative or endovascular treatments, emphasizing the diagnostic challenges, individualized surgical strategies, and clinical outcomes, along with a review of current literature. Methods: Three patients with imaging-confirmed compressive IJVS underwent Doppler ultrasound, 3D computed tomography venography, and magnetic resonance imaging. All patients receivedtargeted surgical decompression via resection of the compressive bony structures, with one patient receiving adjunctive venous stenting due to persistent flow limitation. Results: All patients achieved significant postoperative improvement, including resolution of head noise and amelioration of associated symptoms. Imaging confirmed improved venous caliber and outflow. Notably, one patient with previous stenting failure benefited from staged decompression and re-intervention, highlighting the value of individualized management. Conclusion: Extrinsic compression is a treatable cause of IJVS. Isolated surgical decompression offers a viable treatment option, particularly in patients unresponsive to endovascular approaches. These cases support the need for greater awareness of compressive IJVS and further studies to refine treatment indications and evaluate long-term outcomes.
Keywords: Internal jugular vein stenosis, Surgical Decompression, TransverseProcess of the Atlas, Venous outflow obstruction, Three-Dimensional CTVenography
Received: 02 Jun 2025; Accepted: 25 Aug 2025.
Copyright: © 2025 Ma, Zhao, Zhu, Peng, Lu, Peng, Xu, Mao and Hu. 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:
Haiyang Ma, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
Zhiqiang Hu, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.