After jugular vein compression surgery, still having problems

@ChristinaBabylon - Your post was very understandable. You do not need to apologize. The translator did a good job of making what you wanted to say very clear. I’m very, very sorry for what your husband is going through & for how long he has been suffering. This is not just difficult for him but also for you and your son.

We have learned via patient experience & research documents that the styloid processes (apophyses) are often not the only cause of internal jugular vein (IJV) compression. Other factors such as the transverse processes of the C-1 or C-2 vertebra (you noted C-2 in your husband’s situation) can continue to cause compression in the vessel even after the styloid is removed . In these situations, a small amount of bone needs to be shaved off of the transverse process to make more room for the IJV to open fully. It does not sound like that was taken into consideration in your husband’s case. Other things that can cause the IJV to remain unopened are compression by a muscle such as the digastric muscle, nerve such as the accessory nerve, scar tissue from a previous injury or surgery, or even other vascular tissues such as an artery or vein. If these aren’t looked for, their role in the compression may not be observed & most doctors who aren’t familiar with IJV compression wouldn’t know to look for something other than the bony compressors i.e. styloid & C-1 or C-2.

As you suggested there is the possibility of compressions in other parts of the vascular system within your husband’s skull or even in his neck that could be causing his current symptoms. An angio/venogram of his head & neck would help to answer if he has a problem within his skull or elsewhere in his neck or both.

Regarding the sleep problem, has your husband tried sleeping with his head & shoulders elevated at night. A wedge pillow can be helpful for that. Also, a number of our members with IJV compression were given a prescription for a blood thinner which helped reduce their symptoms until they had surgery to correct the problem. That is something your husband could request & at least try for a month to 6 weeks to see if it helps.

It does occasionally happen that a person’s IJV which has been decompressed does not stay open on it’s own because it has been compressed for so long, but often the pressure of the blood will help it stay open once it is decompressed. Your husband would have to get new diagnostic imaging done to look at the condition of his IJVs now to see if they look open & healthy or still closed up.

Here is a post with some information about jugular stents. Surgery with Hepworth coming up in early May - #6 by Barrootz

Overall we think they should be avoided if at all possible. It’s especially important if your husband were to get a stent that the cause of the IJV compression has been fully resolved because stents are prone to bend when put under pressure by an external force such as the one causing the IJV to continue to suffer compression. A bent stent permanently closes off the vessel since stents can’t be removed & can cause terrible pain. Jugular stents also tend to migrate which means they move out of the area where they are placed & into another part of the vein which can cause additional problems.

I would recommend you try to get a consult with Dr. Costantino in New York. He has done quite a few IJV decompression surgeries and could be very helpful for you. He does video consults, but he would need to see your husband’s diagnostic imaging ahead of time.

•Dr Peter Costantino, 4 Westchester Park Dr, 4th floor, White Plains, (914) 517-8056
http://www.nyhni.org/find-a-physician/Peter-D-Costantino-MD,FACS

If you were to consider a stent, I’d recommend an appointment with Dr. Fargen in North Carolina - Kyle M. Fargen, MD, MPH, FAANS | Atrium Health Wake Forest Baptist

I hope this helps & I hope other members will offer suggestions as well. I will pray for you & your husband to get the answers you need for his recovery. :hugs: :pray:

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