Internal jugular vein stenosis induced by C1 transverse process successfully treated with venous stenting: A case report

Internal Jugular Vein (IJV) compression is a common cause of cerebral venous hypertension symptoms such as headache and pulsatile tinnitus. Various causes are identified with cervical compression by the C1 transverse process being a rare one. Surgical styloidectomy and transverse process resection are commonly performed to relieve the pressure placed upon the IJV, however, minimally invasive treatments such as venous stenting are promising solutions. A 73-year-old patient presented to our outpatient clinic with peripheral vertigo, nystagmus, and gait instability. Computed tomography revealed stenosis of the left IJV caused by compression from the C1 transverse process. This rare anatomical variant was treated successfully with venous stenting, leading to significant symptomatic improvement. This case highlights the importance of considering extracranial venous stenosis as a differential diagnosis in patients with unexplained vertigo and demonstrates the utility of advanced endovascular techniques in managing such cases. This case illustrates that clinical presentation of venous hypertension could rarely be caused by extrinsic compression of jugular veins, either by vertebral transverse processes or styloid processes. Although generally treated surgically, we consider that minimally invasive endovascular venous stenting is a potentially effective treatment strategy. This is demonstrated by venous manometric pressure improvement and symptom resolution in the presented patient. This treatment approach deserves further research to demonstrate its clinical impact, recommendations, and long-term impact.