WARNING - GRAPHIC VISUAL INFORMATION: IJV Compression - Another Point of View

Below is a link to a YouTube video which discusses & partially shows the decompression of IJV compression in a person who has Eagle Syndrome. In this case, the elongated styloid process was not at fault for the compression. I am providing this information because we’ve had several members who have had IJV compression which was assumed to be caused by styloid elongation, but in the end, the cause of the problem had another source, & thus, styloid removal did not allow the IJV to re-open.

If you have been diagnosed with IJV compression, it may be worthwhile to visit a vascular surgeon/neurosurgeon as well an ENT or Head/Neck surgeon to try to ascertain the cause of your vascular compression prior ES surgery. In some cases, the true situation won’t be visible until the patient’s neck is opened & the IJV can be seen & cause of constriction assessed. Additionally, I now believe it is a good idea to consider having a vascular &/or neurosurgeon work alongside an ENT or Head/Neck surgeon in cases of vascular ES where styloid impingement isn’t clearly the problem.

WARNING - The video contains graphic visual information as well as a verbal description of the surgery. It’s about 8 min. long.

Thank you to @TheDude for sending us another VERY HELPFUL link.


Would Hepworth know how to deal with jugular compression? You have commented on my post before. I had noted severe jugular compression by C1 but angiogram normal so I don’t think neurosurgeon will take my case.

I saw ENT today who said I had slightly elongated styloid (3cm) and calcified ligament but she wasn’t comfortable doing surgery.

I expect Dr. Hepworth would be willing to see you for evaluation at the very least. He tends to send his vascular ES patients off for further evaluation. Just make sure if you do end up seeing a vascular doc that you make sure you’re tested with your head in the provocative position & not in neutral. You can ask Dr. Hepworth or whoever refers you for that to be part of the the testing order.

I’m seeing Dr Hui, a NS at hopkins as well in a month. They mentioned he may order a CTV and talked about doing it in different positions I believe.


Always love informative videos. Thanks

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If Dr. Hepworth says you should see a different doctor but doesn’t have a referral, and you can travel, Dr. Omlie in MN may be a viable option. He’s the vascular surgeon who performed my surgery for vascular eagles. Good luck getting treatment and questions answered!


Thanks for this Isaiah! Also adding to my list to watch.

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That was cringeworthy to watch, but really educational!

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I see Hepworth and he has diagnosed me with the jugular compression type. He seems knowledgable and on task.


That’s great news nnaeve! I hope you’re able to have surgery soon so you can begin healing.

Great information! Thanks for sharing!

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Is that Dr still doing Eagle surgery?

It’s unclear what Dr. Lawton does. He has not been willing to help any of our members who have contacted him recently. He has very narrow parameters for determining what is ES & what isn’t. People w/ CT scans & clear ES diagnoses have been turned away.

You are certainly welcome to contact him, but he hasn’t been added to our list because no one here has seen him for surgery. The video was posted as additional information regarding a particular case of vascular ES where an “outside of the box” surgery was performed to correct the problem. Dr. Lawton did not end up removing that patient’s styloids. It is clear that he fixed the cause of the jugular compression but unclear if that patient will go on to have future problems w/ ES because Dr. Lawton left the styloids in place.

Here is a link to the posts by recent members: