Found an interesting article about IJV (Internal Jugular Vein) compression. Apparently it is quite a common issue, and the cause might be either styloid processes OR posterior belly of the digastric muscle. The article admits that at the time of research there was little information about such condition (and possible symptoms caused by the condition). What I especially like is the CT scan images showing what it is like to have compressed vein on the CT scan.
Unrestricted access: http://www.ajnr.org/content/33/7/1247
BACKGROUND AND PURPOSE: Little is known about how commonly the internal jugular vein is compressed by extrinsic structures in the upper neck. The purpose of this paper was to identify the frequency and cause of external compression of the superior segment of the internal jugular vein.
MATERIALS AND METHODS: Retrospective review of CT angiograms of the neck was performed in 108 consecutive patients. Axial source images were evaluated for moderate (>50%) or severe (>80%) stenosis of the internal jugular vein on the basis of external compression. The cause of extrinsic compression was also recorded. In cases with stenosis, the presence of ipsilateral isoattenuated collateral veins was recorded and considered representative of collateral flow.
RESULTS: Moderate stenosis was seen in 33.3% of right and 25.9% of left internal jugular veins. Severe stenosis was seen in 24.1% of right and 18.5% of left internal jugular veins. The most common causes of extrinsic compression included the styloid process and the posterior belly of the digastric muscle. In patients with severe internal jugular vein stenosis, 53.8% of right sides and 55% of left sides had associated condylar collaterals.
CONCLUSIONS: Extrinsic compression of the superior segment of the internal jugular vein is a common finding in unselected patients, often caused by the styloid process or the posterior belly of the digastric muscle. Presence of severe stenosis is not universally associated with collateral formation.
Thanks, that’s really helpful! I’ll have a good study of that.
How are you doing?
Hard to say… Keeping myself entertained by watching educational youtube videos like this one: https://www.youtube.com/watch?v=FyWRWONeFW4
P.S. That’s one of the funniest but at the same time very informative anatomy lessons I’ve recently watched. Watching this, I realised that my inability to do proper nodding (flexion) is likely related to the thick and long styloid processes that are going very close to the spine, and likely touch the atlas’s transverse processes preventing from doing proper “nod”.
P.P.S. This article (https://www.mdpi.com/2411-5142/1/1/126) seems to support my hypothesis. Quote:
In cases with a prolonged styloid process, the transverse process of C1 approaches the styloid in a flexed head position (Figure 10). As a result, no further segmental movement between the occiput and atlas could be observed in a flexed position (Figure 11). In contrast, complex combined 3D movements were possible during axial rotation in an extended position. This may be of great relevance for clinicians when evaluating or treating mobility disorders of the upper cervical spine. Forced rotation in flexion may harm the osseus and vulnerable tissue laying in between.
Thank you for the great article/video links. Good for you using your down time educationally! I would have been watching mindless movies rather than learning something. I applaud you for being productive. I took two years of orthopedic Pilates instructor training which was very anatomy intensive. I do appreciate fun anatomy presentations. Those make learning the details so much more fun.
I’ve forgotten if you’ve found a doctor to do your ES surgery yet? I expect you’ve seen the names of doctors in your country on our “Countries Outside the US Doctors’ List”.
I hope you don’t have to travel cross country to get help, but at least there are some doctors in Canada who do a good job w/ ES surgery.
Please keep us updated on your treatment progress.
Great paper! Thanks so much