We had an appointment with our cardiologist and were discussing the potential jugular decompression surgery with Dr Hepworth, for our daughter. The cardiologist expressed concern about the fact that a jugular with poor blood flow can have clots inside, which makes sense to me…I just never thought that far. He told me to be sure the surgeon evaluates the compressed jugulars carefully, in case there would be any clots that would hinder blood flow after decompression. Could a clot potentially cause a life threatening situation? How common is this and do the surgeons generally evaluate these patients for clots? Any and all thoughts are appreciated! Thank you!
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The cardiologist has brought up an interesting concern. It’s a subject worth discussing with Dr. Hepworth.
If I understand correctly, clots in the jugulars almost never cause problems in the brain as the blood flowing through them is leaving the brain. It’s the carotids that are at greater risk for causing a stroke since blood flows into the brain through the carotids & a clot in a carotid is thus carried into the brain with the blood.
Dr. Hepworth is consistent about Rxing a blood thinner (usually Brilinta) for his patients with IJV compression to take for several months prior to surgery. His primary reason is because it can help reduce the nasty vascular symptoms caused by the dysfunctional IJV. However, I will speculate that if there are clots in the IJV, the blood thinner would help dissolve those which would remove any risk they might cause post op.
There have been mentions of this as a risk for IJV compression, not so much for the risk of a stroke as with ICA compression but more for the risk of a pulmonary embolism, @KoolDude posted a link to a research paper:
Cerebral venous sinus thrombosis caused by styloid jugular vein compression syndrome - General / Research Papers - Living with Eagle
As @Isaiah_40_31 says though, if anti-coagulants are taken this would alleviate the risk.
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Thank you for your great recall, @Jules. I had forgotten about that paper, & discussion.
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Thank you so much for the replies and the info! I appreciate it! So my daughter is taking the natural blood thinner. It does seem to help mildly with her elevated intercranial pressure symptoms. A huge difference would have been welcome but we all know that even a mild improvement is special when you feel so very crummy. Will the natural blood thinner work as well to dissolve clots (providing there are any) as well as prescription drugs? I’m not sure I’d really be able to get my PCP to prescribe one. Or does anyone from Dr Hepworth’s office do it for you if you’ve had a consultation there? Just some things I’m wondering. It’s ok if no body really knows the answers, just asking for previous experiences if there are any. 
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I don’t know the answer to your question about whether a natural blood thinner would actually dissolve a clot, but good there’s been a small improvement in her symptoms…
When she has surgery, make sure you do speak to the surgical team well beforehand to find out when to come off the medication.
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Thanks, I will do that,
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@Rosa, Dr. Hepworth or one of his NPs can/will Rx a blood thinner for your daughter if you request it. As far as whether an Rx blood thinner is better than a natural one at dissolving clots, I’m not sure. It may be an Rx blood thinner could be more effective because those may come in various strengths where I’m not sure the natural ones do.
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