Venous outflow of the brain after bilateral complete jugular ligation.
A case of a patient with bilateral internal, external, posterior external and anterior jugular vein ligations and excisions performed in the neck due to a larynx tumor is presented. Radical neck dissection is a standard otorhinolaryngological procedure in the management of head and neck cancer patients with bilateral lymph node metastasis to the neck. Sacrifice of both internal and external jugular veins bilaterally has been recognized as a dangerous approach leading to intracranial hypertension with subsequent neurological sequela and death. In this report, we aimed to demonstrate how venous outflow from the brain diverts after jugular venous system obliteration. After bilateral jugular vein ligations, digital subtraction angiography (DSA) showed that the venous drainage route of the brain had been diverted from the jugular veins to the vertebral venous plexus.
Ensari
Serdar
S
Ankara Numune Education and Research Hospital, Department of Otorhinolaryngology, Ankara, Turkey.
Kaptanoğlu
Erkan
E
Tun
Kağan
K
Gün
Taylan
T
Beşkonakli
Etem
E
Celikkanat
Serdar
S
Dere
Hüseyin
H
Cekirge
Saruhan
S
D015901:Angiography, Digital Subtraction; D001921:Brain / Q000098:blood supply; D001929:Brain Edema / Q000473:pathology / Q000503:physiopathology; D002533:Cerebral Angiography; D002550:Cerebral Veins / Q000502:physiology*; D003097:Collateral Circulation / Q000502:physiology*; D006801:Humans; D007601:Jugular Veins / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000601:surgery*; D008026:Ligation; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*