Journal of cerebrovascular and endovascular neurosurgery最新文献

{"title":"Dupilumab therapy for atopic dermatitis and aneurysmal subarachnoid hemorrhage: A case report and literature review.","authors":"Hyun Jeong Lee, Jeong Jin Park, Jin Pyeong Jeon, Jong-Kook Rhim","doi":"10.7461/jcen.2026.E2025.12.004","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2025.12.004","url":null,"abstract":"<p><p>Dupilumab is a human IgG4 monoclonal antibody that inhibits IL-4 and IL-13 signaling through IL-4Rα, thereby reducing Th2-mediated inflammation. Although it has demonstrated significant efficacy in the treatment of atopic dermatitis, its long-term vascular safety profile remains incompletely understood. We report a case of a 27-year-old male who developed sudden headache after physical exertion while receiving Dupilumab therapy for two years. Brain computed tomography revealed subarachnoid hemorrhage, and angiography demonstrated a ruptured dissecting aneurysm in the distal posterior cerebral artery. The patient underwent successful stent-assisted coil embolization, and follow-up imaging confirmed complete occlusion without neurological deficits. Dupilumab therapy was discontinued after the procedure. Although Dupilumab effectively suppresses allergic inflammation, chronic inhibition of the anti-inflammatory cytokines IL-4 and IL-13 signaling may theoretically influence vascular homeostasis through alterations in inflammatory pathways. Such mechanisms could potentially affect endothelial stability or thrombo-inflammatory balance. Given the inherent limitations of a single case report, a causal relationship cannot be established. However, this case raises the possibility of an association between prolonged Dupilumab therapy and cerebrovascular vulnerability, highlighting the need for further investigation into the vascular effects of long-term cytokine inhibition.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The half-century evolution of therapeutic strategies for blood blister-like aneurysms of the internal carotid artery.","authors":"Youngjin Jung","doi":"10.7461/jcen.2026.E2026.04.001","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2026.04.001","url":null,"abstract":"<p><strong>Background: </strong>Blood blister-like aneurysm (BBA) of the internal carotid artery (ICA) has posed a formidable challenge for over five decades because of their extreme wall fragility and the absence of a discernible neck. This review synthesizes landmark studies from 1969 to 2025 to trace the historical evolution of therapeutic paradigms and define contemporary standards.</p><p><strong>Methods: </strong>We reviewed historical milestones, including early morphological observations by Sundt (1969) and Nakagawa (1986), the conceptual birth of \"Chimame\" by Takahashi (1988), and histological proof of internal elastic lamina (IEL) disintegration by Ishikawa (1997). Furthermore, we analyzed failures of early endosaccular coiling, the introduction of flow diverters (FDs), and comprehensive meta-analyses from 2024 to 2025.</p><p><strong>Results: </strong>Early microsurgical approaches were associated with high intraoperative rupture rates, while simple coiling frequently resulted in immediate recurrence and morphologic expansion because of the lack of a stable neck. However, the \"stent-within-a-stent\" innovation by Kim et al. (2007) and the first FD application by Rasskazoff et al. (2010) successfully shifted the focus from endosaccular filling to endoluminal reconstruction. Recent 2025 meta-analyses confirm that FD-based reconstruction achieves a pooled complete occlusion rate of 84.0% and favorable clinical outcomes (mRS 0-2) in 89.0% of patients. Notably, functional outcomes between endovascular and microsurgical treatment were comparable (p >0.05), suggesting that both modalities remain viable options, with treatment selection guided by individual patient factors and institutional expertise.</p><p><strong>Conclusions: </strong>Contemporary management of BBAs has significantly evolved toward a dual paradigm: flow diverter-assisted coiling or high-density braided stent-assisted coiling. By addressing the underlying histological focal wall defect through advanced endoluminal scaffolding, these strategies have provided a more predictable therapeutic pathway for what was once a highly precarious vascular condition. However, given the rarity of these lesions, further long-term prospective data remain essential to definitively establish these reconstructive techniques as the primary standard of care.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-stratified analysis of mechanical thrombectomy in octogenarians and nonagenarians: An institutional experience with focus on medical complications as independent predictors of functional outcomes.","authors":"Seung Yoon Song, Dong Hoon Lee, Jae Hoon Sung, Sinho Park, Sol Hooy Oh","doi":"10.7461/jcen.2026.E2025.11.008","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2025.11.008","url":null,"abstract":"<p><strong>Objective: </strong>To identify clinically relevant age cutoffs and prognostic factors influencing functional outcomes in patients over 80 years undergoing mechanical thrombectomy (MT) for acute ischemic stroke (AIS).</p><p><strong>Methods: </strong>We analyzed 108 patients aged ≥81 years treated with endovascular therapy between January 2015 and September 2020. Recursive partitioning analysis identified the optimal age cutoff at 85.5 years, stratifying patients into younger (age<85.5, n=68) and older (age≥86, n=40) groups. Baseline characteristics, procedural metrics, and clinical outcomes were compared. Univariate and multivariate logistic regression analyses identified independent predictors of a favorable outcome (modified Rankin Scale ≤2 at 90 days).</p><p><strong>Results: </strong>Overall the favorable outcome was 38.9%, with significant differences between age groups (48.5% vs. 22.5%, P=0.007). Successful recanalization rates were similar (88.2% vs. 92.5%, P=0.479). Age≥86 years, higher initial National Institutes of Health Stroke Scale, longer procedure time, and medical complications, including pulmonary complications and acute kidney injury, were significant in univariate analysis. Multivariate analysis identified age≥86 years (OR 3.463, 95% CI 1.033-11.611, P=0.044), initial NIHSS (OR 1.146, 95% CI 1.048-1.252, P=0.003), procedure time (OR 1.033, 95% CI 1.013-1.054, P=0.001), pulmonary complications (OR 3.459, 95% CI 1.040-11.505, P=0.043), and acute kidney injury (OR 7.690, 95% CI 1.073-55.097, P=0.042) as independent predictors of unfavorable outcome.</p><p><strong>Conclusions: </strong>Age significantly affects functional outcomes in patients over 80 years old receiving MT. While procedural recanalization success remains high, medical complications, particularly pulmonary and renal complications, emerge as critical independent predictors of poor prognosis in this elderly population. Enhanced perioperative management of medical comorbidities may improve outcomes.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct intragraft thrombectomy as a rescue strategy for early bypass occlusion: Case report and literature review.","authors":"Takashi Mizowaki","doi":"10.7461/jcen.2026.E2026.04.002","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2026.04.002","url":null,"abstract":"<p><p>Early occlusion of a superficial temporal artery-middle cerebral artery (STA-MCA) bypass is an uncommon but critical complication. I report a case of postoperative day 1 graft occlusion with preserved recipient artery flow that was successfully salvaged approximately 35 hours after the index surgery. Direct intragraft thrombectomy through multiple longitudinal arteriotomies, combined with a new STA-MCA anastomosis and perioperative antithrombotic therapy, restored bypass patency. The patient was discharged without neurological deficit; early postoperative angiography confirmed patency, and long-term patency was confirmed by magnetic resonance imaging/magnetic resonance angiography (MRI/MRA) and arterial spin labeling at 2 years. I additionally reviewed the literature on rescue strategies and related clinical courses for occluded or flow-compromised extracranial-intracranial (EC-IC) bypass grafts, including surgical revision, pharmacologic fibrinolysis, endovascular treatment, and observation. This case highlights that, when recipient arterial flow is preserved and thrombus is mainly located within the donor graft, direct intragraft thrombectomy may provide a practical salvage option for early bypass failure.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors of cerebral vasospasm associated with ruptured arterio-venous malformation: A systematic review and meta-analysis.","authors":"Luh Ari Devanita S, I Gede Raka Adhyatma, Kadek Kristian Dwi Cahya","doi":"10.7461/jcen.2026.E2025.12.003","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2025.12.003","url":null,"abstract":"<p><strong>Objective: </strong>Cerebral vasospasm (CVS) could be an undetected reason for worsening condition in ruptured arteriovenous malformation (AVM) patients during the course. It is important to investigate the risk factors associated with vasospasm in order to establish preventive and therapeutic treatments in a timely manner. This study aimed to describe the risk factors of CVS associated with ruptured AVM.</p><p><strong>Methods: </strong>We systematically searched electronic databases (PubMed, Science Direct, Cochrane Library, and SSRN) for studies assessing risk factors of CVS associated with spontaneous ruptured AVM. Risk factors assessed include demographic conditions, comorbidities, substance use, lab and vital parameters, and also the severity of bleeding. Meta-analysis was performed using data extracted from each study then Review Manager was used to analyze the risk ratio (RR) with 95% confidence intervals (95% CI).</p><p><strong>Results: </strong>There were a total of 14 studies included. Chronic renal disease (RR=0.5 [95% CI 0.46-0.67]) and hyperlipidemia (RR=0.78 [95% CI 0.73-0.84]) as comorbid conditions both were found as protective factors. Then the use of substances, including smoking and stimulants, was found to tend to increase the incidence of CVS (RR=1.31 [95% CI 1.11-1.54] and RR=1.31 95% CI 1.11-1.51]) respectively. In the lab and vital parameters section, 8 of them showed results as risk factors for CVS, including leukocytosis (RR=1.58 [95% CI 1.35-1.84]), hyperglycemia (RR=1.17 [95% CI 1.07-1.29]), hyponatremia (RR=1.45 [95% CI 1.23-1.71]), hypokalemia (RR=1.28 [95% CI 1.20-1.36]), fever (RR=1.38 [95% CI 1.23-1.54]), hypovolemia (RR=1.39 [95% CI 1.15-1.67]), acute hypotension (RR=1.4 [95% CI 1.26-1.55]), and electrocardiogram (ECG) abnormality (RR=1.74 [95% CI 1.34-2.26]).</p><p><strong>Conclusions: </strong>Chronic renal disease and hyperlipidemia were found as protective factors. Meanwhile, smoking, stimulant use, leukocytosis, hyperglycemia, hyponatremia, hypokalemia, fever, hypovolemia, acute hypotension, and ECG abnormalities are risk factors for CVS in patients with AVM rupture.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the evidence on endovascular management of chronic subdural hematomas: A scoping review.","authors":"Javier Elizondo-Ramirez, Katya Elizabeth Unzueta-Villalobos, Carlos Mauricio Antillon-Elias, Jose Carlos Herrera-Castro, Oscar José Torres-Figueroa, Luis Alberto Ordonez-Solorio","doi":"10.7461/jcen.2025.E2025.07.003","DOIUrl":"https://doi.org/10.7461/jcen.2025.E2025.07.003","url":null,"abstract":"<p><strong>Objective: </strong>To systematically map the currently available evidence from clinical trials on middle meningeal artery embolization (MMAE) for chronic subdural hematoma (cSDH) and propose potential management pathways for patient selection. This is critical given that cSDH represents a growing neurosurgical challenge, and surgical drainage (burr-hole craniostomy or craniotomy) remains the current gold standard treatment.</p><p><strong>Methods: </strong>A scoping review was conducted following the PRISMA-ScR protocol to map emerging trials and systematically identify critical knowledge gaps. The search covered international public clinical trial registries using specific terms like \"chronic,\" \"subdural hematoma,\" and \"embolization.\" A rigorous selection process was used for active clinical trials comparing the minimally invasive MMAE option with the conventional surgical approach.</p><p><strong>Results: </strong>The initial search yielded 27 active clinical trials. Only 4 (14.8%) are currently completed, with 13 (48.1%) in the recruitment phase. The remaining 37% are classified as active, withdrawn, or of unknown status. Only three active studies (EMBOLISE, MAGIC-MT, and STEM) have published relevant partial results. To date, no high-level evidence has demonstrated that MMAE is superior to conventional surgery.</p><p><strong>Conclusions: </strong>Based on the synthesis of available trial data, a potential management algorithm is proposed for the endovascular treatment of cSDH. MMAE has emerged as a promising option for reducing recurrence, but it has not yet supplanted surgery as the standard of care. Knowledge gaps persist regarding optimal timing, the utility of adjunct therapies, and long-term outcomes, but this algorithm establishes a foundation for future high-quality studies.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel application of the NeVa VS device in the management of severe vasospasm after meningitis.","authors":"Stephen Jaffee, Romil Singh, Praneetha Bheemarasetty, Nihas Mateti, Seung Jeong, Hassan Abdullah Shakeel, Mokshal Porwal, Andrew Ku","doi":"10.7461/jcen.2026.E2025.11.001","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2025.11.001","url":null,"abstract":"<p><p>Cerebral vasospasm is a reversible narrowing of intracranial arteries that most commonly occurs after aneurysmal subarachnoid hemorrhage but can also result from central nervous system infections. Infectious vasospasm poses unique therapeutic challenges, as traditional medical and endovascular interventions are not well established in this context. This report presents a case of severe infectious vasospasm following bacterial meningitis and subdural empyema treated successfully with the NeVa VS retrievable stent device. A male in his twenties developed progressive hemiparesis and vasospasm of the right supraclinoid internal carotid and middle cerebral arteries, confirmed on angiography. Initial intra-arterial verapamil provided only a transient improvement. Due to hemodynamic instability, endovascular angioplasty was performed using the NeVa VS retrievable stent, resulting in restored vessel caliber and cerebral perfusion. The patient subsequently underwent empyema evacuation and showed significant neurological recovery. This case demonstrates the feasibility and potential benefit of retrievable stent angioplasty for refractory infectious cerebral vasospasm, extending the utility of the NeVa VS device beyond its established role in aneurysmal subarachnoid hemorrhage-related vasospasm.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dural arteriovenous fistula of the hypoglossal canal treated with endovascular embolization using 3D Slicer-based preoperative planning: Case report.","authors":"Haesung Sohn, Jaewoo Chung","doi":"10.7461/jcen.2026.E2026.03.001","DOIUrl":"https://doi.org/10.7461/jcen.2026.E2026.03.001","url":null,"abstract":"<p><p>Hypoglossal canal dural arteriovenous fistulas (HC-dAVFs) are rare skull base vascular lesions with complex venous drainage. We report a case of a 52-year-old man who presented with 6 months of left-sided pulsatile tinnitus, sleep disturbance, and anxiety. Magnetic resonance angiography demonstrated venous engorgement near the left hypoglossal canal, and transfemoral cerebral angiography revealed early venous shunting involving the anterior condylar confluence, internal jugular vein, vertebral venous plexus, and cavernous sinus. Conventional workstation-based three-dimensional (3D) reconstruction was limited by poor differentiation of arterial and venous structures, particularly on lateral views. To better delineate the fistulous anatomy, 3D Slicer was used to independently segment arterial and venous phases from DICOM source images and generate a color-coded fused model. This reconstruction clarified the spatial relationship among the feeding arteries, draining veins, and fistulous convergence point, facilitating microcatheter trajectory planning and accurate transvenous access. Transvenous coil embolization via the right femoral vein achieved complete obliteration of the fistula. The patient's pulsatile tinnitus resolved immediately, and no postoperative neurological deficits were observed, including preserved cranial nerve IX through XII function. Follow-up at 1 month and 1 year confirmed sustained complete remission without recurrence. This case highlights the value of 3D Slicer-based preoperative reconstruction for precise angioarchitectural analysis and procedural planning in HCdAVFs when conventional 3D workstation imaging is limited by vessel overlap.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148255201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Futile recanalization after mechanical thrombectomy in patients with acute ischemic stroke and large ischemic core.","authors":"Yuichiro Tsuji, Kohei Tsujino, Ryokichi Yagi, Ryo Hiramatsu, Yoshitaka Yamada, Masahiko Wanibuchi","doi":"10.7461/jcen.2025.E2025.09.001","DOIUrl":"10.7461/jcen.2025.E2025.09.001","url":null,"abstract":"<p><strong>Objective: </strong>Multiple randomized controlled trials have demonstrated the efficacy of mechanical thrombectomy (MT) for acute ischemic stroke with a large ischemic core caused by large-vessel occlusion. Despite successful recanalization, more than half of the patients do not achieve a favorable prognosis, a phenomenon referred to as futile recanalization (FR). We aimed to identify the risk factors for, and incidence of, FR in patients with large ischemic cores.</p><p><strong>Methods: </strong>Eighty-four patients with a large ischemic core who underwent MT between January 2015 and December 2024 at three hospitals were retrospectively reviewed. Patients were divided into two groups-FR and no-FR-according to functional independence at 90 days (modified Rankin Scale (mRS) score ≥4). Factors influencing FR were identified using multivariate logistic regression and receiver operating characteristic curve analyses.</p><p><strong>Results: </strong>Eighty-four patients fulfilled the inclusion criteria, and FR was observed in 57 patients (67.9%). Multivariable regression analysis revealed that older age (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.01-1.18; P=0.011), concomitant diabetes (OR, 11.2; 95% CI, 1.13-111.1; P=0.012), diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score (OR, 0.32; 95% CI, 0.11-0.79; P=0.012), and an increased number of passes (OR, 1.91; 95% CI, 1.00-4.16; P=0.046) were independently associated with FR after MT.</p><p><strong>Conclusions: </strong>Older age, concomitant diabetes, diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score, and an increased number of passes are independently associated with FR after MT in patients with a large ischemic core.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"152-158"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13334147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145852156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internal jugular vein stenosis induced by C1 transverse process successfully treated with venous stenting: A case report.","authors":"Oscar Gutierrez-Trevino, Hector R Martinez, Rogelio Flores-Salcido, Beatriz Perez-Martinez, Enrique Caro-Osorio, Gerardo Lozano-Balderas, Jose A Figueroa-Sanchez","doi":"10.7461/jcen.2026.E2025.10.011","DOIUrl":"10.7461/jcen.2026.E2025.10.011","url":null,"abstract":"<p><p>Internal Jugular Vein (IJV) compression is a common cause of cerebral venous hypertension symptoms such as headache and pulsatile tinnitus. Various causes are identified with cervical compression by the C1 transverse process being a rare one. Surgical styloidectomy and transverse process resection are commonly performed to relieve the pressure placed upon the IJV, however, minimally invasive treatments such as venous stenting are promising solutions. A 73-year-old patient presented to our outpatient clinic with peripheral vertigo, nystagmus, and gait instability. Computed tomography revealed stenosis of the left IJV caused by compression from the C1 transverse process. This rare anatomical variant was treated successfully with venous stenting, leading to significant symptomatic improvement. This case highlights the importance of considering extracranial venous stenosis as a differential diagnosis in patients with unexplained vertigo and demonstrates the utility of advanced endovascular techniques in managing such cases. This case illustrates that clinical presentation of venous hypertension could rarely be caused by extrinsic compression of jugular veins, either by vertebral transverse processes or styloid processes. Although generally treated surgically, we consider that minimally invasive endovascular venous stenting is a potentially effective treatment strategy. This is demonstrated by venous manometric pressure improvement and symptom resolution in the presented patient. This treatment approach deserves further research to demonstrate its clinical impact, recommendations, and long-term impact.</p>","PeriodicalId":94072,"journal":{"name":"Journal of cerebrovascular and endovascular neurosurgery","volume":" ","pages":"184-189"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13334148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}