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Ear, nose and throat
Cerebral venous thrombosis: an unanticipated consequence of unilateral internal jugular vein ligation
  1. Areej Moideen1,
  2. Smriti Panda2,
  3. Jasmine Parihar3 and
  4. Sanjay Kumar Meena4
  1. 1Otorhinolaryngology, All India Institute of Medical Sciences, New Delhi, Delhi, India
  2. 2Otorhinolaryngology, National Cancer Institute-All India Institute of Medical Sciences New Delhi, New Delhi, Delhi, India
  3. 3Neurology, All India Institute of Medical Sciences, New Delhi, Delhi, India
  4. 4Radiodiagnosis, National Cancer Institute, All India Institute of Medical Sciences, New Delhi, Delhi, India
  1. Correspondence to Dr Smriti Panda; smriti.panda.87{at}gmail.com

Abstract

Retrograde cerebral venous thrombosis (CVT) is a rare complication following internal jugular vein (IJV) ligation. The patient described in this report is a male in his 30s with locally advanced carcinoma tongue. He underwent near-total glossectomy and bilateral neck dissection. Due to heavy nodal burden, his right IJV had to be sacrificed. The patient presented with features of raised intracranial pressure (ICP) postoperatively. Magnetic resonance venogram of the brain revealed CVT involving sigmoid and transverse sinus. This case report describes a perplexing case of right-sided IJV ligation giving rise to CVT, resulting in raised ICP. Although the contralateral cerebral venous system was found to be normal, it failed to compensate for the obstructed outflow on the affected side. In this case report, we have elucidated the possible mechanism for the development of raised ICP and described the management in the light of existing evidence.

  • Warfarin therapy
  • Head and neck cancer
  • Head and neck surgery
  • Otolaryngology / ENT
  • Oral and maxillofacial surgery

https://doi.org/10.1136/bcr-2024-261523

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, analysing investigation results, drawing original diagrams and algorithms, and critical revising the important intellectual content: AM and SP. The following authors gave final approval of the manuscript: SP, JP and SKM.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.