• Yume Suzuki, Naoki Toma, Yusuke Kuroda, Yoichi Miura, Masato Shiba, Ryuta Yasuda, and Hidenori Suzuki.
• Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Japan.
• World Neurosurg. 2020 Dec 1; 144: 154-161.

BackgroundAn elongated styloid process can less frequently lead to symptomatic compression of the internal jugular vein (IJV). We present the first case of dural arteriovenous fistula (DAVF) in association with compressed IJV by an elongated styloid process.Case DescriptionA 77-year-old woman presented with pulsating tinnitus. DAVF at the right hypoglossal canal was diagnosed, and she underwent transvenous embolization. The shunt flow was reduced, and the symptom disappeared after transvenous embolization. However, 2 years and 8 months later, retrograde sinus drainage from the residual shunt was asymptomatically found on magnetic resonance imaging, and angiography revealed progression of IJV stenosis caused by an elongated styloid process. Subsequently, she underwent a second transvenous embolization, and the arteriovenous shunt was almost completely obliterated.ConclusionsThe present case suggests that venous hypertension by compressed IJV can induce the development of DAVF. It is helpful for the diagnosis and treatment of DAVF to keep in mind the possibility of IJV stenosis owing to an elongated styloid process.Copyright © 2020 Elsevier Inc. All rights reserved.

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