Turkish Neurosurgery 2008 , Vol 18 , Num 1
Venous Outflow of the Brain after Bilateral Complete Jugular Ligation
Serdar ENSARİ1, Erkan KAPTANOĞLU2, Kağan TUN3, Taylan GÜN4, Etem BEŞKONAKLI5, Serdar ÇELİKKANAT6, Hüseyin DERE7, Saruhan ÇEKİRGE8
1,4,6,7Ankara Numune Education and Research Hospital, Department of Otorhinolaryngology, Ankara, Turkey
2,3,5Ankara Numune Education and Research Hospital, Department of Neurosurgery, Ankara, Turkey
8Hacettepe University, Faculty of Medicine, Department of Radiology, Ankara, Turkey
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. Keywords : Brain, Edema, Jugular vein, Obstruction, Radical neck dissection
Corresponding author : Erkan Kaptanoğlu, erkankaptanoglu@yahoo.com