Journal Article

Headache in Patients With Non‐Thrombotic Internal Jugular Vein Stenosis: Clinical Characteristics and Associated Risk Factors in a Retrospective Study of 283 Cases

Wan, Shuling, Meng, Ran, Ji, Xunming, Zhou, Da, Han, Guangyu

2025

Overview

Aims This study aimed to characterize the clinical features of headache in patients with non‐thrombotic internal jugular vein stenosis (IJVS) and to identify associated risk factors. Methods This retrospective study consecutively enrolled patients with imaging‐confirmed non‐thrombotic IJVS from January 2021 through July 2024. Participants were divided into IJVS‐headache and IJVS‐without‐headache groups based on clinical symptoms. Demographic, clinical, neuroimaging, and treatment data were reviewed in detail. Univariate and multivariate logistic regression analyses were performed to determine risk factors for headache. Results Among 283 eligible patients (median age: 51 years in the IJVS‐headache group vs. 56 years in the IJVS‐without‐headache group, p < 0.001), 65.02% reported headache. Most headaches were chronic (82.07%), generalized (85.87%), and moderate in intensity (53.26%), with notable daily life impact (57.61%). Univariate analysis showed that headache was significantly associated with visual disturbances (p = 0.010), elevated cerebrospinal fluid opening pressure (p < 0.001), high jugular bulb (p = 0.007), and severe scalp vein dilation (p < 0.001), but inversely associated with severe vertebral vein expansion (p < 0.001). Multivariate regression revealed that high jugular bulb (OR = 3.144, 95% CI: 1.083–9.123, p = 0.035), severe scalp vein dilation (OR = 2.142, 95% CI: 1.068–4.294, p = 0.032), and protein C or S deficiency (OR = 5.984, 95% CI: 1.196–29.928, p = 0.029) were independent risk factors, whereas severe vertebral vein expansion was protective (OR = 0.184, 95% CI: 0.092–0.366, p < 0.001). Conclusions Headache represents a prevalent and often disabling symptom in non‐thrombotic IJVS, underpinned by distinctive vascular and hematologic profiles. Identification of high‐risk patients based on neuroimaging and thrombophilia screening may facilitate personalized interventions and improve symptom control. Approximately two‐thirds of non‐thrombotic IJVS patients experienced headache, generally moderate, chronic, and diffuse. Identifying clinical and neuroimaging risk factors of headache may help guide individualized management strategies to reduce headache occurrence.

• Publisher: John Wiley & Sons, Inc,Wiley
• Subject: Adult / Aged / Blood clots / Body mass index / Catheters / Cerebrospinal fluid / clinical characteristics / Constriction, Pathologic - complications / Constriction, Pathologic - diagnostic imaging / Constriction, Pathologic - epidemiology / Female / Headache / Headache - diagnostic imaging / Headache - epidemiology / Headache - etiology / Headaches / Hepatitis B / Humans / internal jugular vein stenosis / Jugular vein / Jugular Veins - diagnostic imaging / Jugular Veins - pathology / logistic regression analysis / Male / Medical imaging / Middle Aged / Neuroimaging / Original / Patients / Protein C / Protein deficiency / Regression analysis / Retrospective Studies / Risk Factors / Scalp / Sinuses / Sleep disorders / Stenosis / Thrombophilia / Thrombosis / Tinnitus / Tomography / Veins & arteries / Vertebrae