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

J Int Med Res. 2021 Apr;49(4):3000605211006609. doi: 10.1177/03000605211006609.

Abstract

Cerebral venous sinus thrombosis (CVST) is a special subtype of stroke that may be life-threatening in severe cases. CVST has distinct risk factors and is frequently overlooked because of its initially nonspecific clinical presentation. We herein describe a 72-year-old man who developed CVST in the right lateral sinus. Despite the absence of common risk factors in this patient, he developed external compression of the bilateral internal jugular veins by a lateral mass of the C1 vertebra and expansion of the carotid artery. Because of his elevated D-dimer and fibrinogen concentrations, which are associated with ongoing activation of the coagulation system, the patient underwent treatment with batroxobin combined with anticoagulation. Recanalization of the sinus was achieved, and his high intracranial pressure and papilledema remarkably decreased. We conclude that external compression of the internal jugular veins, which can be identified with three-dimensional computed tomography venography, may be an important risk factor for CVST.

Keywords: Lateral sinus thrombosis; batroxobin; case report; computed tomography venography; internal jugular vein; risk factors; venous insufficiency.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Brachiocephalic Veins
  • Fibrinogen
  • Hemostatics*
  • Humans
  • Jugular Veins / diagnostic imaging
  • Male
  • Sinus Thrombosis, Intracranial* / diagnostic imaging
  • Sinus Thrombosis, Intracranial* / drug therapy
  • Sinus Thrombosis, Intracranial* / etiology

Substances

  • Hemostatics
  • Fibrinogen