Abstract
Objective Eagle’s ‘jugular’ syndrome is a rare cause of headache, related to an elongated styloid process impinging the internal jugular vein (IVJ) and altering dynamic intracranial pressure. This case series reports two cases of Eagle’s ‘jugular’ syndrome and the use of a minimally invasive, vascular surgical technique as management.
Case The first case is of a 78 year old male with a two week history of bilateral retro-orbital pain that radiated into the neck and shoulders and was increased by turning the head. CT venogram and MRI venogram demonstrated bilateral IVJ stenosis with no other significant pathology. A staged bilateral IVJ stent was inserted and there was complete resolution of the pain. The second case is of a 49 year old with a 3 month history of bifrontal pain with temporal radiation. Photophobia, phonophobia and left facial numbness were also reported. No papilloedema was present but lumbar puncture opening pressure was 28 cm of water, with acellular CSF. CT venogram and MRI venogram demonstrated bilateral IVJ stenosis with no other significant pathology. A right IVJ stent was inserted. Whilst a post-procedure LP demonstrated a lower opening pressure of 20 cm, the patient reported no improvement in headache symptoms.
Conclusion With contrasting outcomes, these cases provide valuable insight into the criteria for diagnosis and treatment for patients suffering from headache due to Eagle’s ‘jugular’ syndrome.
