Diplopia as a sequel of unilateral neck dissection

Head Neck. 2016 Aug;38(8):E2475-8. doi: 10.1002/hed.24428. Epub 2016 Apr 4.

Abstract

Background: The purpose of this study was to discuss the underlying etiology of raised intracranial pressure and its sequel after unilateral internal jugular vein ligation. In addition, the management protocol for such rare cases has been discussed along with literature review.

Methods: PubMed and Google were used to search the literature for cases of raised intracranial pressure with complications after unilateral internal jugular vein (IJV) ligation. Twelve case reports with 17 patients were identified.

Results: There were 13 male and 4 female patients ranging between the ages of 26 and 61 years. Headache (n = 12/17; 70.5%), diplopia (n = 10/17; 58.8%), impaired vision (n = 9/17; 52.9%), and aplasia or hypoplasia of the transverse sinus were seen in these patients.

Conclusion: Although very rare, this potential complication after unilateral IJV ligation should be kept in mind. Magnetic resonance venogram (MRV) is the investigation of choice to ascertain the underlying etiology. Conservative management should be started immediately. Surgical options are reserved for patients with progressive symptoms. © 2016 Wiley Periodicals, Inc. Head Neck, 2016 © 2016 Wiley Periodicals, Inc. Head Neck 38:E2475-E2478, 2016.

Keywords: aplasia or hypoplasia of transverse sinus; diplopia; headache; internal jugular vein ligation; neck dissection.

Publication types

  • Review

MeSH terms

  • Adult
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Diplopia / diagnostic imaging
  • Diplopia / etiology*
  • Diplopia / therapy
  • Female
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / surgery
  • Headache / diagnostic imaging
  • Headache / etiology*
  • Headache / therapy
  • Humans
  • Intracranial Hypertension / diagnostic imaging
  • Intracranial Hypertension / etiology*
  • Intracranial Hypertension / therapy
  • Jugular Veins / diagnostic imaging
  • Jugular Veins / surgery*
  • Ligation / methods
  • Magnetic Resonance Angiography / methods
  • Male
  • Middle Aged
  • Neck Dissection / adverse effects*
  • Neck Dissection / methods
  • Rare Diseases
  • Risk Assessment
  • Sampling Studies
  • Squamous Cell Carcinoma of Head and Neck
  • Treatment Outcome