DOI: https://doi.org/10.36347/sasjm.2026.v12i02.013

Pages: 140-143

Background: Styloidogenic Jugular Venous Compression Syndrome (SJVCS) is a rare variant of Eagle Syndrome in which an elongated styloid process mechanically obstructs the internal jugular vein (IJV), leading to venous outflow obstruction and intracranial hypertension-like symptoms. Case Report: We present the case of a 35-year-old female with a two-year history of progressive bilateral facial pain and cervicogenic headaches. Uniquely, her symptoms were aggravated not only by head rotation but significantly by cervical flexion ("looking down"). Computed tomography (CT) revealed bilateral styloid elongation (38 mm right, 33 mm left) causing compression of the IJVs against the lateral masses of the C1 vertebrae. Contrast-enhanced CT ruled out thrombosis, while Doppler ultrasonography confirmed hemodynamic significance, demonstrating pre-stenotic venous stasis and post-stenotic velocity acceleration. Conclusion: The patient underwent bilateral transcervical styloidectomy with complete resolution of symptoms. This case highlights the importance of recognizing cervical flexion as a potential provocative maneuver for SJVCS, which may indicate a C1 osseous conflict. It further supports the utility of Doppler ultrasonography as a functional adjunct to static CT imaging in confirming the diagnosis.