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01-09-2023 | Idiopathic Intracranial Hypertension | Original Article

Extreme lateral infracondylar approach for internal jugular vein compression syndrome: A case series with preliminary clinical outcomes

Authors: Kaiyun Yang, Kevin Shah, Sabrina L. Begley, Giyarpuram Prashant, Timothy White, Peter Costantino, Athos Patsalides, Sheng-Fu Larry Lo, Amir R. Dehdashti

Published in: Acta Neurochirurgica | Issue 11/2023

Abstract

Background and objectives

Internal jugular vein (IJV) stenosis is associated with several neurological disorders including idiopathic intracranial hypertension (IIH) and pulsatile tinnitus. In cases of extreme bony compression causing stenosis in the infracondylar region, surgical decompression might be necessary. We aim to examine the safety and efficacy of surgical IJV decompression.

Methods

We retrospectively reviewed patients who received surgical IJV decompression via the extreme lateral infracondylar (ELI) approach between July 2020 and February 2022.

Results

Fourteen patients with IJV stenosis were identified, all with persistent headache and/or tinnitus. Six patients were diagnosed with IIH, three of whom failed previous treatment. Of the eight remaining patients, two failed previous treatment. All underwent surgical IJV decompression via styloidectomy, release of soft tissue, and removal of the C1 transverse process (TP). Follow-up imaging showed significant improvement of IJV stenosis in eleven patients and mild improvement in three. Eight patients had significant improvement in their presenting symptoms, and three had partial improvement. Two patients received IJV stenting after a lack of initial improvement. Two patients experienced cranial nerve paresis, and one developed a superficial wound infection.

Conclusion

The ELI approach for IJV decompression appears to be safe for patients who are not ideal endovascular candidates due to bony anatomy. Confirming long-term efficacy in relieving debilitating clinical symptoms requires longer follow-up and a larger patient cohort. Carefully selected patients with symptomatic bony IJV compression for whom there are no effective medical or endovascular options may benefit from surgical IJV decompression.

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Title: Extreme lateral infracondylar approach for internal jugular vein compression syndrome: A case series with preliminary clinical outcomes
Authors: Kaiyun Yang
Kevin Shah
Sabrina L. Begley
Giyarpuram Prashant
Timothy White
Peter Costantino
Athos Patsalides
Sheng-Fu Larry Lo
Amir R. Dehdashti
Publication date: 01-09-2023
Publisher: Springer Vienna
Keywords: Idiopathic Intracranial Hypertension
Tinnitus
Headache
Published in: Acta Neurochirurgica / Issue 11/2023
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-023-05779-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Extreme lateral infracondylar approach for internal jugular vein compression syndrome: A case series with preliminary clinical outcomes

Abstract

Background and objectives

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and objectives

Methods

Results

Conclusion

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