Styloid–C1 internal jugular vein compression associated with spontaneous cervical epidural hematoma: A case report

Background: Spontaneous cervical epidural hematoma (SCEH) is a rare condition, and its etiology remains unclear in the majority of cases. Styloidogenic jugular venous compression syndrome (SJVCS) represents impaired internal jugular vein (IJV) outflow between the styloid process and the C1 vertebra and has been associated with several venous hypertension–related disorders, which likely include SCEH. Case Description: A patient presented with an acute SCEH immediately after straining. Imaging revealed a narrow styloid–C1 corridor with the IJV coursing directly posterior to the styloid process (i.e., a retrostyloid configuration). Cervical computed tomography angiogram demonstrated morphologic features suggesting jugular venous compression at the J3 level. Notably, neither an arterial lesion nor an arteriovenous malformation was identified. Conclusion: The anatomical configuration, suspected dynamic venous obstruction, and temporal association with straining supported a venous pathophysiological mechanism resulting in an SCEH attributed to a narrow styloid–C1 corridor with the IJV.