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Cerebral venous sinus thrombosis due to external compression of internal jugular vein

Jingwei Guan1,2,3, Siying Song1,2,3, Wei Wang1

  • 1Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.

The Journal of International Medical Research
|April 13, 2021
PubMed

Insights

Cerebral venous sinus thrombosis (CVST) can be life-threatening. External jugular vein compression, identified via CT venography, may be a key risk factor for CVST, even without typical causes.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Radiology

Background:

  • Cerebral venous sinus thrombosis (CVST) is a rare stroke subtype with nonspecific symptoms, often leading to delayed diagnosis.
  • Identifying unique risk factors is crucial for understanding and managing CVST.
  • Traditional risk factors for CVST were absent in the described patient.

Observation:

  • A 72-year-old male presented with CVST in the right lateral sinus.
  • The patient had external compression of bilateral internal jugular veins due to a C1 vertebra mass and carotid artery expansion.
  • Elevated D-dimer and fibrinogen indicated coagulation system activation.

Findings:

  • Treatment with batroxobin and anticoagulation led to sinus recanalization.
  • Significant reduction in intracranial pressure and papilledema was observed post-treatment.
  • Three-dimensional computed tomography venography identified external jugular vein compression.

Implications:

  • External compression of internal jugular veins is proposed as a significant, previously unrecognized risk factor for CVST.
  • This finding may improve diagnostic strategies for CVST, especially in cases lacking common risk factors.
  • CT venography is highlighted as a valuable tool for detecting this specific anatomical risk factor.

Keywords:
Lateral sinus thrombosisbatroxobincase reportcomputed tomography venographyinternal jugular veinrisk factorsvenous insufficiency

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