Https://onlinelibrary.wiley.com/doi/full/10.1111/cns.13148

https://onlinelibrary.wiley.com/doi/full/10.1111/cns.13148

For those who have vascular Eagle’s - it may be known as “Cervical spondylotic internal jugular venous compression syndrome”.

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This is exactly what my neurologist called it after reviewing my CT before sending me to the surgeon :sweat_smile:

Thanks VDM, will have a read, sounds very helpful!

Hooray for complicated names to describe vascular compression caused by ES!! :crazy_face:

I was absolutely astonished that the article never mentions “Eagle’s syndrome” nor uses any sources to it in the reference list. And maybe for good. As we all know, some doctors simply “don’t believe” in Eagle’s as it sounds like healing magnets magic stones. Though they might believe in “Cervical spondylotic internal jugular venous compression syndrome”.

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Caveat: I am not a doctor, BUT after perusing the article, I wonder if the resection of the transverse process(es) (TP) of the C1 vertebra was necessary in every case.

The 3D image presented in the top picture set (below) shows a person with extremely elongated styloid processes & IJV compression. The styloid in the 3D image in the bottom picture set (below) is harder to see, but the caption states the IJV compression is being caused by the left styloid.

I propose from this, & other information in the article, that it may be unidentified Eagle Syndrome causing the compression in both cases & that the removal/shortening of the TP of the C1 vertebra was unnecessary. If the styloid process(es) alone were removed, the patient could potentially have the same result as w/ resection of both styloid & TP of C1. The surgery would be less complex & recovery easier w/ only styloid resection.

Caveat: I have no doubt that there are cases where the TP(s) of C1 can interfere w/ vascular tissues in the area. They are subject to the same “laws” of calcification as are the styloids i.e. if the body senses extra support is needed in the area due to repetitive motion or other injury, aging, etc., it will be laid down, & thus the TPs could eventually extend into the space where the IJVs “live” & cause a problem. My concern here is that, at least in some cases, unnecessary surgery was done.


Neuroimaging features of right IJVS induced by the C1 transverse mass. Sagittal (A), axial (B), and 3D reconstructive (D) CTV images revealing the right transverse mass of C1 compression on the right IJV. MRV © revealing the right IJV‐J3 segment stenosis accompanied by substantially abnormal collateral veins


Neuroimaging features of left IJVS induced by the styloid process. Axial, (A) and 3D reconstructive (B) CTV images showing the left IJVS present the left styloid process compression on the left IJV. MRV © and CTV (D) showing the left IJV‐J3 segment stenosis accompanied by substantially abnormal collateral veins

Hi Isaiah

I have just been looking at these images. Still awaiting my Ctv results and undiagnosed :tired_face: it’s torture

I always presumed that my c1 transverse process was the main issue. But looking at my images and those in the article my styloid does seem involved. Mainly on right side. It would be great if a styloidectomy alone could help with this.

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Hi Natty,

Once the styloid is removed there’s a good chance the IJV will move over into the new space created & your vascular compression will take care of itself w/o anything needing to be done to your cervical vertebra. We can pray for that. :blush:

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Thank you for your prayers. :heartbeat: This outcome and symptom resolve would be the best gift I could ever wish for.

What is ICA?

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On the image 553/608 it shows the left side jugular vein pretty compressed by the styloid too. Which side do you have most problem with, or are they both the same?
Hopefully removing the styloid will be enough to help your veins go back to normal, & nothing will be needed to be done to the C1 process. I’m sure that Mr Axon will be able help you looking at these!

My mistake, Natty, sorry! ICA is internal carotid artery. Your issue is a compressed IJV - internal jugular vein. I corrected my post. Regardless, I hope for the same outcome, just a different blood vessel. :wink:

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I get confused Jules (doesn’t take much these days lol) so my right side is my dominant jugular which is being most compressed. Which appears on the left side of my ct image.

My left jugular which appears on the right side of my ct image I disregarded tbh. I thought the styloid was only partially touching it. My left jugular is hypoplastic and narrow throughout.

On my ultrasound I have high velocity in the mid section on my right side. Which would make sense as it’s the vein being most compressed.

In terms of symptoms they are all over but mainly at the back of my head. When I get pulsing pain it tends to be on my right side but then I find my left ear feels more blocked and I get this drainage feeling in my ear and back of the head on my left side.

The pulling of my eyes and this sucking numb brain feeling is all over and mainly at the back. And no joke the back of my head and neck feels so weird and numb.

All so hard to explain

Yes, the vascular symptoms are horrible & very hard to explain, just plain weird! Mr Axon will go through the CTs with you, he’s good…& advise which side to do first. Have you got a date to see him? There’s such a backlog with covid :disappointed:

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They are unimaginable aren’t they. I would class myself as fairly articulate and at times I just want to say “look it feels awful and weird and numb but full and floaty but heavy” :joy:

Tbh I’m not even looking that far ahead. I still have impending doom that Mr Axon is going to say all normal. I’ve heard “unremarkable” so many times since becoming sick, that I’m so scared to even entertain “we have a diagnosis for you”

You know on my left side which is right sided in the imaging. I doubt he will even take that side in to consideration as it doesn’t look compressed but I’m not 100%

I’m sure he’ll confirm it- he’s very knowledgeable about IH & asked me lots about my symptoms. Do you get pulsatile tinnitus too? He’s done research about that so was very interested when I mentioned that symptom! Keep strong, I’m sure he’ll help you :pray:

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Thanks Jules. Really appreciate it. :heartbeat: yes I have whooshing tinnitus sometimes on changes of movement. Such as standing from sitting etc

Will keep you posted

Just geeking around with my images, whilst I wait for what feels like a 100 years for my results.

The blood flow in my dominant jugular almost becomes transparent at the site of compression.

Are the jugular veins really important for brain function etc? And could compression cause issues with vision etc and to visually feel spacey like I’m drunk etc

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Compressed jugular could lead to intracranial hypertension which yes, can affect your vision. My understanding is that that is one of the biggest risks as the increased pressure can affect the optic nerve and eventually lead to vision loss if not treated. My doctor suspects intracranial hypertension due to my IJV compression and one of the first things he did was refer me to an eye doctor who examined my optic nerve. The exam showed nothing wrong with my optic nerve but I also wasn’t having any vision disturbances or symptoms. At your appointment I’d definitely ask the doctor about intracranial hypertension.

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Thanks blossom. I’ve had my eyes checked numerous times and they say all ok but my mri shows evidence of optic nerve sheath dilation

I’m now under mr Axon who is one of the best in the uk for this.

Is there anything else linked to jugular compression or is it just hypertension? As in if the brain can’t drain it’s going to give you high pressure and the vein is not responsible for anything else?

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image

This was part of a report when I had my mri privately reviewed.

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