Cerebral venous sinus thrombosis caused by styloid jugular vein compression syndrome

[KoolDude]

This is yet another case of Styloid compression causing Cerebral Venous Sinus clotting. This article is recent one ( Feb 2022) and comes from Korean Neurological Association regarding a 47 year old man who came down with severe headache and came to the emergency. It seems that the prevalence of clotting induced by vascular ES might be under reported. I posted an article of 36 year old case in an earlier article (shown below).

So after all, it is well known that Jugular Vein Stenosis (regardless of the cause - muscle, bone, tumor…etc) puts you at risk of clotting as previous study (Nonthrombotic internal jugular venous stenosis may facilitate cerebral venous thrombosis - PMC) has found. I also know that a number of our community here suffer from clotting along with vascular ES so this is yet another confirmation that compression does put you at higher risk of cerebral venous sinus clotting. The mechanism behind venous clot formation according to literature are not well understood but are associated with Virchow Triad namely, Static blood flow, Endothelial Injury (Vessel wall Injury) and Hyper-coagulability (Pregnancy/Malignancy/Genetic predisposition to clotting). I think the first 2 can be attributed to Styloid compression as it can cause blood to backup ( Static blood flow) and Vessel wall injury (Endothelial Injury) by a repeated bone compression.

@KoolDude

Here is an interesting case of 36 year old woman with long styloid process on the left side compressing her jugular vein and transverse sinus thromboses. She was treated with anticoagulation medicine since she refused styloidectomy. Her symptoms improved after the anticoagulation which I think it was to do with the thromboses (clotting) than the compression of the jugular vein.

Stylo-Jugular Venous Compression Syndrome: Lessons Based on a Case Report

Cerebral venous sinus thrombosis is a rare form of cerebrovascular disease, accounting for only about 0.5-1% of all strokes. Cerebral venous sinus thrombosis can show a variety of clinical symptoms, including headache, which is the most common symptom reported in more than 90% of all patients, convulsions, focal neurological deficit, change of consciousness, and optic disc edema. etc. In addition, a wide variety of causes and various antecedent factors are known. Among them, there are coagulopathy-related diseases in which thrombus can form well and drugs including oral contraceptives, pregnancy and late childbirth, and in addition to cancer , parameningeal infection, trauma, and surgery. However, it is known that the cause is unknown in about 12.5% ​​of all patients, so it may be difficult to differentiate the cause of the disease and determine the treatment policy accordingly [ 1 ]. The authors reported that the styloidogenic jugular venous compression syndrome is caused by compression of the internal jugular vein between the styloid process and the transverse process of the first cervical vertebra. We experienced a very rare case of cerebral venous sinus thrombosis and would like to report it.

Study Link : https://www.jkna.org/journal/view.php?number=6871

NOTE: The study might be in Korean but you can translate it into any language.

[elijah]

Yup. I have a clot in my left IJV above the occlusion and I know another member who has a clot in his jugular bulb due to his IJV stenosis.

I would venture to say that there probably also cases where IJV stenosis leads to clots forming higher up in the sigmoid sinus and transverse sinus. Overall, it’s just further proof how understudied this all is.

[KoolDude]

I agree with you. This is much more dangerous than just ES as it can cause death if the clot was to travel down to the heart and lungs area AKA Pulmonary embolism, much like how Deep Vein Thrombosis (DVT) causes death. Also, if upper brain sinuses are affected, it can potentially lead to permanent brain injury. So getting the nasty compression out of the way goes beyond relieving ES symptoms.