Clinical Symptoms of Jugular Venous Outflow Obstruction and Their Modification After Targeted Surgical Treatment

BACKGROUND AND OBJECTIVES: Cerebral venous outflow disorders (CVD) are conditions characterized by impairment of cerebral venous drainage. Associated symptoms have been poorly defined, as no standardized diagnostic criteria exist for this class of conditions; most studies to date have attempted to report on symptoms solely based on suggestive noninvasive imaging findings, which is prone to selection bias. The aim of this study was to characterize symptoms that may be present in the setting of suspected internal jugular vein outflow stenosis. METHODS: A survey was conducted among patients with suspected CVD who had previously undergone diagnostic dynamic cerebral venography and subsequent internal jugular vein stenting or styloidectomy from 2019 to 2025. RESULTS: Following distribution to 133 patients, 60 (45.1%) responded. Fifty (83.3%) of the 60 respondents indicated an improvement in symptoms following intervention. Brain fog (49, 98.0%), headache (48, 96.0%), and fatigue/low energy (46, 92.0%) were the most frequently reported symptoms pre-procedure. Uncontrollable seizures or shaking spells, headache, and eye pain were the most responsive to intervention, with improvement rates of 87.5%, 81.3%, and 81.0%, respectively. Nineteen of 50 respondents endorsed a diagnosis of Postural Orthostatic Tachycardia Syndrome; 8 of 19 reported improvement in Postural Orthostatic Tachycardia Syndrome symptoms after their procedure. CONCLUSION: There is a wide range of symptoms that may be present in patients with CVD. This survey illustrates the most common complaints among suspected patients with CVD and elicits which symptoms are likely due to cerebral venous outflow impairment, based on responsiveness to intervention.