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The omohyoid muscle entrapment of the internal jugular vein. A still unclear pathogenetic mechanism

Sergio Gianesini1, Erica Menegatti1, Francesco Mascoli2,
Fabrizio Salvi3, Stefano Bastianello4 and Paolo Zamboni1

Abstract
Objectives: To evaluate the role of the omohyoid muscle anatomic variants as a possible reversible cause of internal
jugular vein extrinsic compression.

Method: We describe a chronic cerebro-spinal venous insufficiency patient, who presented a omohyoid muscle entrapment
of the internal jugular vein, confirmed by both magnetic resonance venography and ultrasound investigation.
A omohyoid muscle surgical transection together with a patch angioplasty was performed.

Results: The surgical procedure led to both IJV flow restoration and neurological improvement.

Conclusions: The omohyoid muscle compression on the internal jugular vein seems to be a possible cause of venous
obstruction, but several anatomical and patho-physiological aspects need further investigations. Such picture might cause
balloon venous angioplasty inefficacy and needs to be preoperatively considered.