Hi, Im Javier and I have bilateral compression of the IJVs by the C1 transverse processes, and I’m trying to understand the possible causes.
It all started after a significant amount of physical strain while I was working as a waiter.
I’m not sure whether the space was anatomically narrow to begin with and the cervical rectification has made it even narrower, whether inflammation of the surrounding tissues is pushing the veins, or whether C1 has shifted out of position.
By the way, I have a congenital C6–C7 fusion, and no craniocervical instability.
Forward head posture and loss of cervical curve move C1 forward into jugular compression but is worsened when elongated styloids or just even unusually angled styloid process sandwich the jugular from the other side.
It would be helpful if you could post some of your CT images for us to look at as we could possibly speculate what has brought on your situation. You can use radiantviewer.com for PCs or Bee Dicom Viewer App for Macs.
@SCJeff has provided an answer that very possibly describes your situation. Here is what the cervical spine should look like & what it looks like w/ the cervical lordotic curve is lost:
Here’s a link to a post w/ more information about how the curve can be corrected, but in some cases, the IJV compression needs to be dealt with surgically first.
Yeah, but my styloids are less than 30 mm. The compression is caused by the C1 transverse processes. Some doctors have told me that my C1 transverse processes are larger than normal, but others said no. that could be part of the cause.
@nemo - Your cervical spine looks great in the row of pictures w/ your neck in flexion, neutral & extension. You may have a slight amount of forward head posture but not enough to be creating the compression.
Reviewing the image that @TML annotated, it looks like the cause of your compression is the transverse processes of C1. Your styloids are quite thick but there appears to be a decent amount of space between the styloids & IJVs.
The reason the TPs of the C1 vertebra eventually cause compression of the IJVs can be unknown. Sometimes it’s due to postural issues, sometimes it’s from a neck injury, sometimes it’s from ligament laxity caused by Ehlers Danlos or other syndromes that affect the ligaments, & sometimes it’s just a congenital anomaly i.e. the way the body developed in the womb. Because your cervical curve looks good, I’d say, your suggestion that IJV compression developed from the work you did as a waiter could be the case combined w/ the natural shape of your C1 TPs which perhaps predisposed you to eventually ending up with what you’re experiencing now. It’s something that could have also developed with age & living an active lifestyle.
I wish there was a clearcut answer, but as with many aspects of ES there are unknown causes.
Thank you,
I was told that I have cervical straightening, and that the congenital C6-C7 fusion may have contributed to it.
If there were ligamentous laxity wouldn’t it show up on dynamic x rays?
There must have been something more than just a congenital anomaly, since I’ve lived without any problems until now.
Is it normal to have pain in my trapezius muscles and to have my neck crack in addition to the more obvious symptoms?
What concerns me is that I may continue to have other symptoms after the surgery, such as neck cracking, pain at the base of my neck and in my trapezius muscles, etc.
Ligament laxity show on a digital motion x-ray; but with ES, because the neck is such a cramped space, we’re talking a shift of just a few millimeters being enough to cause compression. We often find that people get more symptoms as they get older- connective tissue weakens with age, and this can be enough to shift the positions of structures in the neck. I didn’t have any vascular symptoms when I was initially diagnosed , they started later , after I had a prolapsed disc C5-C6. I’ve always presumed this shifted things enough to start IJV compression, I was doing lots of exercise too which probably made things worse.
Neck cracking is quite common, but this can happen without it being ES. Trapezius pain could be the spinal accessory nerve, it’s commonly affected with ES.
But can there be displacement without craniocervical instability?
Would you say that my C1 transverse processes were larger than normal due to genetics, and that the workload from my job, together with the congenital fusion of C6–C7, narrowed the space even further?
Not sure if this is helpful information or not. But I have severe jugular compression with C1 on my right side and mild compression. My scans show that I have large lateral veins in general, and more of them than the average person on the right side.
I had an angiogram and venogram performed, and even though I have more narrowing with two head positions, the pressure in my head does not change. In other words, my body overtime has compensated for the compression. And I was told that decompression of my jugulars would do little too no good for me.
I’m not sure if this information is helpful or what you’re fully asking cause you’re looking for a cause. I definitely know my eagle syndrome is linked to my jugular compression. From your scans I didn’t really see your styloid on there. But perhaps they aren’t calcified. Or maybe you’re just wondering if you have Eagle syndrome? If nothing else, I hope the information I shared about my large veins could give some insight and maybe direction of what you want to be asking your doctor the next time you see him.
What are your symptoms? Do you have ringing in your ears? Does it change when you change the position of your head, like in Indian dances, when you move your head left and right in the same plane?
You say you have compression but no symptoms, right? I understand that it’s common for there to be stenosis in the body’s veins without causing major problems or symptoms.
In my case, it’s not typical Eagle syndrome, since it’s the transverse processes of C1 not the styloids that are compressing the jugular veins. Still, over time, the body learns to adapt to a problem like this with collateral veins.
You move your head sideways to the left -right, you do not turn, but move to the side, shift your head to the side, do not tilt.it is better not to do this, if you try, then do it very carefully and slowly. Can you share dicom CT? google drive here Google drive here or or via email filatovtechgmailcom______). at first glance, you don’t have developed venous collaterals-vertebral veins.
What are your symptoms? Do you have ringing in your ears? Does it change when you change the position of your head, like in Indian dances, when you move your head left and right in the same plane?
I have at least one symptom connected to my jugular vein compression on the right side that was proven with the venogram, but it is considered not dangerous because the gradient pressure is in my head do not change.
