{"title":"Case Report: Isolated surgical decompression for compressive internal jugular vein stenosis: case series and literature review.","authors":"Haiyang Ma, Rui Zhao, Shuaibin Lu, Weicheng Peng, Xupeng Peng, Sheng Xu, Beibei Mao, Guangtong Zhu, Zhiqiang Hu","doi":"10.3389/fsurg.2025.1639108","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1639108"},"PeriodicalIF":1.6000,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479468/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fsurg.2025.1639108","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
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Abstract
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.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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