ArticleDiagnostics (Basel, Switzerland)2023
Styloid Jugular Nutcracker: The Possible Role of the Styloid Process Spatial Orientation-A Preliminary Morphometric Computed Study.
Article in Diagnostics (Basel, Switzerland), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 12 citations in OpenAlex.
- Compression Syndromes of the Stylohyoid Complex: Neural, Arterial, and Venous Phenotypes in a Dynamic Neurovascular Corridor.Tomography (Ann Arbor, Mich.) · 2026Review
- Anatomical characteristics of the styloid process associated with internal carotid artery dissection: a systematic review and meta-analysis of controlled trials.Frontiers in radiology · 2026Review
- Styloid-C1 internal jugular vein compression associated with spontaneous cervical epidural hematoma: A case report.Surgical neurology international · 2026Article
- Cervicobrachialgia in a female in her fourth decade of life: Have Eagle's syndrome and thoracic outlet syndrome been considered?Anales del sistema sanitario de Navarra · 2025Article
- Anatomical Reasons for an Impaired Internal Jugular Flow.Medicina (Kaunas, Lithuania) · 2025Review
- Internal jugular vein compression: A benign entity or an underappreciated phenomenon?eNeurologicalSci · 2025Article
- "Winged" Eagle's syndrome: neurophysiological findings in a rare cause of spinal accessory nerve palsy. Illustrative cases.Journal of neurosurgery. Case lessons · 2023Article
- Details of rare and novel anatomical variations in a case with bilateral long styloid processes.Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologieArticle
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Authors and funding
11 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
Styloid Jugular Nutcracker (SJN, also known as Eagle Jugular Syndrome EJS) derives from a jugular stenosis caused by an abnormal styloid process, compressing the vessel in its superior portion (J3) against the C1 anterior arch. It could be considered a venous vascular variant of Eagle Syndrome (ES). Main clinical features of this ES variant are headache, pulsatile tinnitus and dizziness, possibly related to venous hypertension and impaired cerebral parenchyma drainage. In our opinion, conceptually, it is not the absolute length of the styloid bone that defines its abnormality, but its spatial direction. An elongated bone pointing outward far away from the midline could not compress the vein; vice versa, a short styloid process tightly adherent to the cervical spine could be pathological. To prove this hypothesis, we developed a semi-automatic software that processes CT-Angio images, giving quantitative information about distance and direction of the styloid process in three-dimensional space. We compared eight patients with SJN to a sample of healthy subjects homogeneous for sex and age. Our results suggest that SJN patients have a more vertically directed styloid, and this feature is more important than the absolute distance between the two bony structures. More studies are needed to expand our sample, including patients with the classic and carotid variants of Eagle Syndrome.
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