{"id":6928,"date":"2026-05-12T18:10:36","date_gmt":"2026-05-12T18:10:36","guid":{"rendered":"https:\/\/kamranaghayev.com\/?p=6928"},"modified":"2026-05-12T20:12:54","modified_gmt":"2026-05-12T20:12:54","slug":"idiyopatik-intrakraniyal-hipertansiyon-nedenleri","status":"publish","type":"post","link":"https:\/\/kamranaghayev.com\/tr\/idiyopatik-intrakraniyal-hipertansiyon-nedenleri\/","title":{"rendered":"Juguler Ven Kompresyonu ve Torasik \u00c7\u0131k\u0131\u015f Sendromu \u0130diyopatik \u0130ntrakraniyal Hipertansiyona Nas\u0131l Yol A\u00e7\u0131yor"},"content":{"rendered":"\n<p>Onlarca y\u0131ld\u0131r <strong>ps\u00f6dot\u00fcm\u00f6r serebri<\/strong> \u2013 modern ad\u0131yla <strong>idiyopatik intrakraniyal hipertansiyon (\u0130\u0130H)<\/strong> \u2013 ad\u0131yla pratik olarak hastaya \u00abbu durumun neden oldu\u011funu bilmiyoruz\u00bb diyen bir tan\u0131 ta\u015f\u0131yor. Hastal\u0131k, <a href=\"https:\/\/kamranaghayev.com\/tr\/beyin-tumoru\/\">beyin t\u00fcm\u00f6r\u00fc<\/a>, <a href=\"https:\/\/kamranaghayev.com\/tr\/hidrosefali\/\">hidrosefali<\/a> veya ba\u015fka bir belirgin yap\u0131sal neden olmaks\u0131z\u0131n y\u00fckselen beyin omurilik s\u0131v\u0131s\u0131 (BOS) bas\u0131nc\u0131 olarak tan\u0131mlan\u0131yor <sup><a href=\"#footnote_1_6928\" id=\"identifier_1_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Friedman DI, Liu GT, Digre KB. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology. 2013;81(13):1159&ndash;1165. doi:10.1212\/WNL.0b013e3182a55f17\">1<\/a><\/sup> Hastalar tipik olarak obez, kad\u0131n ve \u00fcreme \u00e7a\u011f\u0131ndad\u0131r <sup><a href=\"#footnote_2_6928\" id=\"identifier_2_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Markey KA, Mollan SP, Jensen RH, Sinclair AJ. Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions. Lancet Neurol. 2016;15(1):78&ndash;91. doi:10.1016\/S1474-4422(15)00298-7\">2<\/a><\/sup> <sup><a href=\"#footnote_3_6928\" id=\"identifier_3_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Mollan SP, Davies B, Silver NC, et al. Idiopathic intracranial hypertension: consensus guidelines on management. J Neurol Neurosurg Psychiatry. 2018;89(10):1088&ndash;1100. doi:10.1136\/jnnp-2017-317440\">3<\/a><\/sup> Klinik tabloya inat\u00e7\u0131 ba\u015f a\u011fr\u0131lar\u0131, pulsatil tinnitus, papil \u00f6demi, ge\u00e7ici g\u00f6rme bulan\u0131kl\u0131klar\u0131 ve ilerleyici g\u00f6rme kayb\u0131 e\u015flik eder <sup><a href=\"#footnote_4_6928\" id=\"identifier_4_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Wall M, Kupersmith MJ, Kieburtz KD, et al. The Idiopathic Intracranial Hypertension Treatment Trial: clinical profile at baseline. JAMA Neurol. 2014;71(6):693&ndash;701. doi:10.1001\/jamaneurol.2014.133\">4<\/a><\/sup><\/p>\n\n\n\n<p>Klasik anlat\u0131 sorumlulu\u011fu obeziteye, hormonlara ve BOS emiliminin belirsiz bir bozuklu\u011funa y\u0131kar. Ancak ger\u00e7ek klinik pratikte bu anlat\u0131, pek \u00e7ok hastay\u0131 yan\u0131ts\u0131z ve etkili uzun vadeli tedavisiz b\u0131rak\u0131yor. Geni\u015fleyen kan\u0131t birikimi, hastalar\u0131n \u00f6nemli bir k\u0131sm\u0131nda y\u00fckselen bas\u0131nc\u0131n asl\u0131nda idiyopatik olmad\u0131\u011f\u0131n\u0131 \u2013 <strong>beynin ven\u00f6z drenaj\u0131ndaki mekanik bir t\u0131kan\u0131kl\u0131\u011f\u0131n<\/strong> sonucu oldu\u011funu \u2013 g\u00f6steriyor <sup><a href=\"#footnote_5_6928\" id=\"identifier_5_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Fargen KM, Midtlien JP, Margraf CR, Hui FK. Idiopathic intracranial hypertension pathogenesis: The jugular hypothesis. Interv Neuroradiol. 2024 Aug 8:15910199241270660. doi:10.1177\/15910199241270660\">5<\/a><\/sup> <sup><a href=\"#footnote_6_6928\" id=\"identifier_6_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Townsend RK, Fargen KM. Intracranial venous hypertension and venous sinus stenting in the modern management of idiopathic intracranial hypertension. Life (Basel). 2021;11(6):508. doi:10.3390\/life11060508\">6<\/a><\/sup> <sup><a href=\"#footnote_7_6928\" id=\"identifier_7_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Bono F, Messina D, Giliberto C, et al. Bilateral transverse sinus stenosis predicts IIH without papilledema in patients with migraine. Neurology. 2006;67(3):419&ndash;423. doi:10.1212\/01.wnl.0000227892.67354.85\">7<\/a><\/sup><\/p>\n\n\n\n<p>En \u00e7ok g\u00f6zden ka\u00e7an iki t\u0131kan\u0131kl\u0131k \u00e7ok \u00f6zg\u00fcl anatomik darbo\u011fazlarda yer al\u0131r: <strong>birinci servikal vertebra (C1) d\u00fczeyindeki internal juguler ven<\/strong> ve <strong>torasik \u00e7\u0131k\u0131\u015ftaki subklavyen-brakiyosefalik ven\u00f6z koridor<\/strong>. \u0130\u0130H tan\u0131s\u0131 alm\u0131\u015f her hastan\u0131n ay\u0131r\u0131c\u0131 tan\u0131s\u0131nda bu iki nokta yer almal\u0131; \u00f6zellikle de kilo kayb\u0131, asetazolamid, lomber ponksiyon, BOS \u015fantlar\u0131 ve hatta ven\u00f6z sin\u00fcs stentlemesine ra\u011fmen belirtileri s\u00fcren hastalarda.<\/p>\n\n\n\n<p>Bu yaz\u0131 s\u00f6z konusu yakla\u015f\u0131m\u0131n gerek\u00e7esini, anatomisini, kan\u0131t temelini ve pratik sonu\u00e7lar\u0131n\u0131 a\u00e7\u0131kl\u0131yor.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Ps\u00f6dot\u00fcm\u00f6r serebri \/ \u0130\u0130H asl\u0131nda nedir \u2013 k\u0131sa bir hat\u0131rlatma<\/h2>\n\n\n\n<p>Ge\u00e7erli tan\u0131 standard\u0131 <strong>2013 Friedman kriterleridir<\/strong> <sup><a href=\"#footnote_1_6928\" id=\"identifier_8_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Friedman DI, Liu GT, Digre KB. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology. 2013;81(13):1159&ndash;1165. doi:10.1212\/WNL.0b013e3182a55f17\">1<\/a><\/sup><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Yayg\u0131n intrakraniyal hipertansiyon belirti ve bulgular\u0131 veya papil \u00f6demi<\/li>\n\n\n\n<li>Kraniyal sinir anormallikleri d\u0131\u015f\u0131nda normal n\u00f6rolojik muayene<\/li>\n\n\n\n<li>Normal n\u00f6rog\u00f6r\u00fcnt\u00fcleme (kitle, hidrosefali veya yap\u0131sal lezyon yok)<\/li>\n\n\n\n<li>Normal BOS bile\u015fimi<\/li>\n\n\n\n<li><strong>Y\u00fcksek lomber ponksiyon a\u00e7\u0131l\u0131\u015f bas\u0131nc\u0131<\/strong> (eri\u015fkinde &gt;25 cm H\u2082O, \u00e7ocukta &gt;28 cm H\u2082O)<\/li>\n<\/ul>\n\n\n\n<p>E\u011fer bir neden \u2013 dural sin\u00fcs trombozu, belirli ila\u00e7lar, endokrin hastal\u0131k \u2013 saptan\u0131rsa olgu <strong>sekonder intrakraniyal hipertansiyon<\/strong> olarak yeniden s\u0131n\u0131fland\u0131r\u0131l\u0131r ve \u00abidiyopatik\u00bb etiketi d\u00fc\u015fer. Sorun \u015fu ki, mevcut paradigmada <strong>klinisyenler ven\u00f6z t\u0131kan\u0131kl\u0131\u011f\u0131 kafatas\u0131 d\u0131\u015f\u0131nda nadiren ara\u015ft\u0131r\u0131r<\/strong>. Standart g\u00f6r\u00fcnt\u00fcleme kafataban\u0131nda durur, hasta tarama s\u0131ras\u0131nda supin pozisyonda ve ba\u015f d\u00fcz konumdad\u0131r; yaln\u0131zca dik pozisyonda veya ba\u015f rotasyonu ile ortaya \u00e7\u0131kan dinamik daralmalar g\u00f6r\u00fcnmez kal\u0131r.<\/p>\n\n\n\n<p>Sonu\u00e7 tahmin edilebilir: net bi\u00e7imde tan\u0131mlanabilir bir mekanik nedeni olan hasta \u00abidiyopatik\u00bb olarak etiketlenir ve semptomatik tedavi al\u0131r.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Klasik demografi ge\u00e7erlili\u011fini koruyor \u2013 ancak hik\u00e2yenin tamam\u0131n\u0131 anlatm\u0131yor<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u0130\u0130H kad\u0131nlarda erkeklere k\u0131yasla <strong>yakla\u015f\u0131k 9 kat daha s\u0131k<\/strong> g\u00f6r\u00fcl\u00fcr <sup><a href=\"#footnote_3_6928\" id=\"identifier_9_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Mollan SP, Davies B, Silver NC, et al. Idiopathic intracranial hypertension: consensus guidelines on management. J Neurol Neurosurg Psychiatry. 2018;89(10):1088&ndash;1100. doi:10.1136\/jnnp-2017-317440\">3<\/a><\/sup><\/li>\n\n\n\n<li>En y\u00fcksek g\u00f6r\u00fclme ya\u015f\u0131 <strong>20\u201340 aras\u0131d\u0131r<\/strong> <sup><a href=\"#footnote_3_6928\" id=\"identifier_10_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Mollan SP, Davies B, Silver NC, et al. Idiopathic intracranial hypertension: consensus guidelines on management. J Neurol Neurosurg Psychiatry. 2018;89(10):1088&ndash;1100. doi:10.1136\/jnnp-2017-317440\">3<\/a><\/sup><\/li>\n\n\n\n<li>Klasik olarak en g\u00fc\u00e7l\u00fc risk fakt\u00f6r\u00fc, hastalar\u0131n %70\u201394&#8217;\u00fcnde bulunan <strong>obezitedir<\/strong> <sup><a href=\"#footnote_2_6928\" id=\"identifier_11_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Markey KA, Mollan SP, Jensen RH, Sinclair AJ. Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions. Lancet Neurol. 2016;15(1):78&ndash;91. doi:10.1016\/S1474-4422(15)00298-7\">2<\/a><\/sup><\/li>\n\n\n\n<li><strong>Hastalar\u0131n %40&#8217;\u0131na varan bir k\u0131sm\u0131nda kal\u0131c\u0131 g\u00f6rme bozuklu\u011fu geli\u015fir<\/strong> ve %1\u201310&#8217;u yasal olarak k\u00f6rl\u00fck tan\u0131m\u0131na girer <sup><a href=\"#footnote_3_6928\" id=\"identifier_12_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Mollan SP, Davies B, Silver NC, et al. Idiopathic intracranial hypertension: consensus guidelines on management. J Neurol Neurosurg Psychiatry. 2018;89(10):1088&ndash;1100. doi:10.1136\/jnnp-2017-317440\">3<\/a><\/sup><\/li>\n<\/ul>\n\n\n\n<p>Bu rakamlar ger\u00e7ek ve obezite ger\u00e7ekten rol oynar \u2013 y\u00fckselen intraabdominal ve santral ven\u00f6z bas\u0131n\u00e7 ger\u00e7ekten intrakraniyal ven\u00f6z bas\u0131nc\u0131 art\u0131r\u0131r <sup><a href=\"#footnote_5_6928\" id=\"identifier_13_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Fargen KM, Midtlien JP, Margraf CR, Hui FK. Idiopathic intracranial hypertension pathogenesis: The jugular hypothesis. Interv Neuroradiol. 2024 Aug 8:15910199241270660. doi:10.1177\/15910199241270660\">5<\/a><\/sup> Ancak yaln\u0131zca obezite, ne zay\u0131f \u0130\u0130H hastas\u0131n\u0131, ne kilo kayb\u0131na ra\u011fmen refrakter seyreden hastay\u0131, ne de <strong>papil \u00f6demi olmayan idiyopatik intrakraniyal hipertansiyon (IIHWOP)<\/strong> hastas\u0131n\u0131 a\u00e7\u0131klayabilir <sup><a href=\"#footnote_8_6928\" id=\"identifier_14_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Mollan SP, Aguiar M, Evison F, Frew E, Sinclair AJ. The expanding burden of idiopathic intracranial hypertension. Eye (Lond). 2019;33(3):478&ndash;485. doi:10.1038\/s41433-018-0238-5\">8<\/a><\/sup><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Juguler ven hipotezi \u2013 birle\u015ftirici bir model<\/h2>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large is-resized\"><img fetchpriority=\"high\" decoding=\"async\" width=\"1024\" height=\"549\" src=\"https:\/\/kamranaghayev.com\/wp-content\/uploads\/2026\/04\/the-atlas-c1-spine-1024x549.webp\" alt=\"\" class=\"wp-image-6856\" style=\"width:600px\" srcset=\"https:\/\/kamranaghayev.com\/wp-content\/uploads\/2026\/04\/the-atlas-c1-spine-1024x549.webp 1024w, https:\/\/kamranaghayev.com\/wp-content\/uploads\/2026\/04\/the-atlas-c1-spine-300x161.webp 300w, https:\/\/kamranaghayev.com\/wp-content\/uploads\/2026\/04\/the-atlas-c1-spine-768x412.webp 768w, https:\/\/kamranaghayev.com\/wp-content\/uploads\/2026\/04\/the-atlas-c1-spine.webp 1267w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\"><em>Atlas (C1), kafatas\u0131n\u0131n oksipital kondilleriyle do\u011frudan eklemle\u015fen birinci servikal vertebra. \u0130nternal juguler ven juguler foramenden ini\u015f yapar ve hemen C1 transvers \u00e7\u0131k\u0131nt\u0131s\u0131n\u0131n lateralinden ge\u00e7er \u2013 bu durum s\u00f6z konusu d\u00fczeyi yap\u0131sal olarak ka\u00e7\u0131n\u0131lmaz bir potansiyel ven\u00f6z risk noktas\u0131 h\u00e2line getirir.<\/em><\/figcaption><\/figure>\n\n\n\n<p>2024 y\u0131l\u0131nda Fargen, Midtlien, Margraf ve Hui, \u0130\u0130H patogenezinin son zamanlardaki en \u00f6nemli yeniden \u00e7er\u00e7evelemesini yay\u0131mlad\u0131: <strong>juguler ven hipotezi<\/strong> <sup><a href=\"#footnote_5_6928\" id=\"identifier_15_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Fargen KM, Midtlien JP, Margraf CR, Hui FK. Idiopathic intracranial hypertension pathogenesis: The jugular hypothesis. Interv Neuroradiol. 2024 Aug 8:15910199241270660. doi:10.1177\/15910199241270660\">5<\/a><\/sup> Merkez\u00ee arg\u00fcmanlar\u0131 \u015fudur: \u0130\u0130H ve onun spektrum bozukluklar\u0131, en iyi \u015fekilde <strong>beynin ven\u00f6z drenaj\u0131 sorunu<\/strong> olarak anla\u015f\u0131l\u0131r ve bu sorunda <strong>internal juguler venler (\u0130JV)<\/strong> birincil, savunmas\u0131z ve s\u0131kl\u0131kla g\u00f6zden ka\u00e7an etken oynar.<\/p>\n\n\n\n<p>Modelleri alt\u0131 maddeye indirgenebilir <sup><a href=\"#footnote_5_6928\" id=\"identifier_16_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Fargen KM, Midtlien JP, Margraf CR, Hui FK. Idiopathic intracranial hypertension pathogenesis: The jugular hypothesis. Interv Neuroradiol. 2024 Aug 8:15910199241270660. doi:10.1177\/15910199241270660\">5<\/a><\/sup><\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>\u0130JV&#8217;ler boyunca t\u00fcm uzunluk \u00fczerinde fizyolojik ve patolojik kompresyona a\u00e7\u0131kt\u0131r<\/strong> \u2013 C1 d\u00fczeyinde stiloid \u00e7\u0131k\u0131nt\u0131 taraf\u0131ndan, C3 ile C6 aras\u0131nda dinamik kas ve karotis ili\u015fkileriyle.<\/li>\n\n\n\n<li><strong>\u015eiddetli dinamik \u0130JV stenozu<\/strong> servikal d\u00fczeyde b\u00fcy\u00fck bas\u0131n\u00e7 gradiyentleriyle birlikte \u0130\u0130H spektrumundaki hastalarda yayg\u0131nd\u0131r ve intrakraniyal ven\u00f6z bas\u0131n\u00e7 ile BOS bas\u0131nc\u0131n\u0131 belirgin bi\u00e7imde etkiler.<\/li>\n\n\n\n<li><strong>Ekstra-juguler kollateral yollar<\/strong> zaman i\u00e7inde geni\u015fler, ancak normal juguler drenaj\u0131n yerini almak i\u00e7in <strong>yetersiz kal\u0131r<\/strong>.<\/li>\n\n\n\n<li>Bozuk \u0130JV drenaj\u0131 intrakraniyal ven\u00f6z hipertansiyon ve konjesyona yol a\u00e7ar; BOS bas\u0131nc\u0131n\u0131 ve intrakraniyal bas\u0131nc\u0131 (\u0130KB) y\u00fckseltir.<\/li>\n\n\n\n<li><strong>Glimfatik sistem<\/strong> de t\u0131kan\u0131r, ancak telafi edemez.<\/li>\n\n\n\n<li>S\u00fcrekli y\u00fcksek \u0130KB sonunda <strong>transvers sin\u00fcs\u00fcn ekstramural kompresyonuna<\/strong> neden olur \u2013 g\u00f6r\u00fcnt\u00fclemede g\u00f6r\u00fclen klasik bulgu, s\u00fcrecin as\u0131l nedeni de\u011fil <strong>g\u00fc\u00e7lendiricisi olarak i\u015flev g\u00f6r\u00fcr<\/strong>.<\/li>\n<\/ol>\n\n\n\n<p>Son madde kritik \u00f6neme sahip ve klinik pratikte d\u00fczenli olarak yanl\u0131\u015f yorumlan\u0131r. <strong>MR venografide transvers sin\u00fcs stenozu, yirmi y\u0131ld\u0131r \u0130\u0130H de\u011ferlendirmelerine h\u00e2kim olan bulgudur; oysa \u00e7ok daha proksimal \u2013 ve fizyolojik olarak \u00e7ok daha \u00f6nemli \u2013 internal juguler vendeki t\u0131kan\u0131kl\u0131k, g\u00f6r\u00fcnt\u00fcleme raporlar\u0131na neredeyse hi\u00e7 girmez.<\/strong> Klinik dikkat ak\u0131\u015f a\u015fa\u011f\u0131s\u0131ndaki sonuca odaklanm\u0131\u015f, ak\u0131\u015f yukar\u0131s\u0131ndaki nedene de\u011fil. \u00abTavuk mu yumurta m\u0131?\u00bb sorusu ilk kez 2002&#8217;de Corbett ve Digre taraf\u0131ndan a\u00e7\u0131k\u00e7a ortaya konuldu <sup><a href=\"#footnote_9_6928\" id=\"identifier_17_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Corbett JJ, Digre K. Idiopathic intracranial hypertension: an answer to &ldquo;the chicken or the egg?&rdquo; Neurology. 2002;58(1):5&ndash;6. doi:10.1212\/wnl.58.1.5\">9<\/a><\/sup>ve o zamandan beri yan\u0131t yeterince netle\u015fti. King ve arkada\u015flar\u0131 ayn\u0131 y\u0131l, BOS bas\u0131nc\u0131n\u0131n lateral C1 \u2013 C2 ponksiyonu ile d\u00fc\u015f\u00fcr\u00fclmesinin do\u011frudan manometri s\u0131ras\u0131nda \u00f6l\u00e7\u00fclen <strong>y\u00fcksek ven\u00f6z sin\u00fcs bas\u0131nc\u0131n\u0131 an\u0131nda \u00e7\u00f6zd\u00fc\u011f\u00fcn\u00fc<\/strong> g\u00f6sterdi <sup><a href=\"#footnote_10_6928\" id=\"identifier_18_6928\" class=\"footnote-link footnote-identifier-link\" title=\"King JO, Mitchell PJ, Thomson KR, Tress BM. Manometry combined with cervical puncture in idiopathic intracranial hypertension. Neurology. 2002;58(1):26&ndash;30. doi:10.1212\/wnl.58.1.26\">10<\/a><\/sup>\u2013 bu g\u00f6zlem, stenozun ak\u0131\u015f yukar\u0131s\u0131ndaki as\u0131l etken olmas\u0131yla temel olarak ba\u011fda\u015fmaz. Sonraki g\u00f6r\u00fcnt\u00fcleme \u00e7al\u0131\u015fmalar\u0131 ayn\u0131 bulguyu defalarca do\u011frulad\u0131: BOS \u00e7ekildikten veya \u015fant uyguland\u0131ktan sonra transvers sin\u00fcs stenozlar\u0131 kateter ve BT venografide \u2013 bazen bir saat i\u00e7inde \u2013 kayboluyor <sup><a href=\"#footnote_11_6928\" id=\"identifier_19_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Scoffings DJ, Pickard JD, Higgins JN. Resolution of transverse sinus stenoses immediately after CSF withdrawal in idiopathic intracranial hypertension. J Neurol Neurosurg Psychiatry. 2007;78(8):911&ndash;912. doi:10.1136\/jnnp.2006.111765\">11<\/a><\/sup><\/p>\n\n\n\n<p>Tarafs\u0131z olmak ad\u0131na: geri d\u00f6n\u00fc\u015f\u00fcml\u00fcl\u00fck evrensel de\u011fil. Bono ve arkada\u015flar\u0131, iki tarafl\u0131 transvers sin\u00fcs stenozu olan on d\u00f6rt \u0130\u0130H hastas\u0131n\u0131 alt\u0131 y\u0131l boyunca seri MR venografilerle izledi ve medikal tedavide BOS bas\u0131nc\u0131 normalle\u015fen dokuz hastada (%64) bile stenozlar\u0131n <strong>devam etti\u011fini<\/strong> buldu <sup><a href=\"#footnote_12_6928\" id=\"identifier_20_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Bono F, Giliberto C, Mastrandrea C, Cristiano D, Lavano A, Fera F, Quattrone A. Transverse sinus stenoses persist after normalization of the CSF pressure in IIH. Neurology. 2005;65(7):1090&ndash;1093. doi:10.1212\/01.wnl.0000178889.63571.e5\">12<\/a><\/sup>\u2013 bu, vakalar\u0131n bir alt grubunda sin\u00fcs\u00fcn art\u0131k tek ba\u015f\u0131na \u0130KB azalmas\u0131na yan\u0131t vermeyen yap\u0131sal bir yeniden \u015fekillenmeden ge\u00e7ti\u011fini d\u00fc\u015f\u00fcnd\u00fcr\u00fcr. De Simone ve arkada\u015flar\u0131 bu kar\u0131\u015f\u0131k g\u00f6zlemleri, kendi kendini s\u0131n\u0131rlayan ven\u00f6z kollaps geri besleme d\u00f6ng\u00fcs\u00fc modelinde sentezledi: BOS bas\u0131nc\u0131ndaki ba\u015flang\u0131\u00e7 art\u0131\u015f\u0131 \u00e7\u00f6kebilir bir sin\u00fcs segmentini s\u0131k\u0131\u015ft\u0131r\u0131r, ortaya \u00e7\u0131kan ven\u00f6z bas\u0131n\u00e7 art\u0131\u015f\u0131 BOS emilimini daha da azalt\u0131r ve her iki bas\u0131n\u00e7 yeni, daha y\u00fcksek bir denge d\u00fczeyinde stabille\u015fir <sup><a href=\"#footnote_13_6928\" id=\"identifier_21_6928\" class=\"footnote-link footnote-identifier-link\" title=\"De Simone R, Ranieri A, Montella S, Bilo L, Cautiero F. The role of dural sinus stenosis in idiopathic intracranial hypertension pathogenesis: the self-limiting venous collapse feedback-loop model. Panminerva Med. 2014;56(3):201&ndash;209.\">13<\/a><\/sup> Bu model her iki tabloyu a\u00e7\u0131klar: baz\u0131 hastalarda d\u00f6ng\u00fc akut BOS \u00e7ekimiyle k\u0131r\u0131l\u0131r ve stenoz geri d\u00f6ner; uzun s\u00fcreli hastal\u0131\u011f\u0131 olan di\u011ferlerinde denge yerle\u015fir ve bas\u0131n\u00e7 normalle\u015fmesine ra\u011fmen stenoz devam eder. Her hal\u00fck\u00e2rda transvers sin\u00fcs stenozu, s\u00fcrecin as\u0131l nedeni de\u011fil <strong>kendi kendini g\u00fc\u00e7lendiren bir kat\u0131l\u0131mc\u0131s\u0131d\u0131r<\/strong>.<\/p>\n\n\n\n<p>Hastalar\u0131n \u00f6nemli bir k\u0131sm\u0131n\u0131n ven\u00f6z sin\u00fcs stentlemesinden sonra n\u00fcks etmesinin nedeni de tam olarak budur. 2024 y\u0131l\u0131nda 24 \u00e7al\u0131\u015fmadaki 694 \u0130\u0130H hastas\u0131n\u0131 i\u00e7eren sistematik derleme ve meta-analiz, <strong>birikimli %17,7 restenoz oran\u0131<\/strong> ve <strong>stentleme sonras\u0131 %22,3 hasta belirtilerinin s\u00fcrd\u00fc\u011f\u00fcn\u00fc veya k\u00f6t\u00fcle\u015fti\u011fini<\/strong> bildirdi; yazarlar bu oranlar\u0131n, prosed\u00fcr\u00fcn daha fazla ara\u015ft\u0131r\u0131lmas\u0131 gerekti\u011fine i\u015faret etti\u011fini belirtti <sup><a href=\"#footnote_14_6928\" id=\"identifier_22_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Lim J, Monteiro A, Kuo CC, Jacoby WT, Cappuzzo JM, Becker AB, Davies JM, Snyder KV, Levy EI, Siddiqui AH. Stenting for Venous Sinus Stenosis in Patients With Idiopathic Intracranial Hypertension: An Updated Systematic Review and Meta-Analysis of the Literature. Neurosurgery. 2024;94(4):648&ndash;656. doi:10.1227\/neu.0000000000002718\">14<\/a><\/sup> Daha eski bir kohort \u00e7al\u0131\u015fmas\u0131nda Ahmed ve arkada\u015flar\u0131, transvers sin\u00fcs stentlemesinden sonra 52 \u0130\u0130H hastas\u0131n\u0131 izledi ve <strong>6 hastada (%11,5) hem y\u00fcksek ven\u00f6z bas\u0131n\u00e7 hem de orijinal stente biti\u015fik yeni bir stenoza ba\u011fl\u0131 belirti n\u00fcks\u00fc<\/strong> geli\u015fti\u011fini, ikinci stentleme prosed\u00fcr\u00fc gerektirdi\u011fini bildirdi; bir hastaya en sonunda d\u00f6rt prosed\u00fcr uyguland\u0131 <sup><a href=\"#footnote_15_6928\" id=\"identifier_23_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Ahmed RM, Wilkinson M, Parker GD, Thurtell MJ, Macdonald J, McCluskey PJ, Allan R, Dunne V, Hanlon M, Owler BK, Halmagyi GM. Transverse Sinus Stenting for Idiopathic Intracranial Hypertension: A Review of 52 Patients and of Model Predictions. AJNR Am J Neuroradiol. 2011;32(8):1408&ndash;1414. doi:10.3174\/ajnr.A2575\">15<\/a><\/sup> Stent sonucu a\u00e7\u0131k tutar; ak\u0131\u015f yukar\u0131s\u0131ndaki t\u0131kan\u0131kl\u0131k \u2013 juguler vende veya daha a\u015fa\u011f\u0131da \u2013 tamamen dokunulmadan kal\u0131r <sup><a href=\"#footnote_5_6928\" id=\"identifier_24_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Fargen KM, Midtlien JP, Margraf CR, Hui FK. Idiopathic intracranial hypertension pathogenesis: The jugular hypothesis. Interv Neuroradiol. 2024 Aug 8:15910199241270660. doi:10.1177\/15910199241270660\">5<\/a><\/sup><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Kompresyon Noktas\u0131 #1: C1 D\u00fczeyinde \u0130nternal Juguler Ven Stenozu (Stiloidojenik Juguler Ven\u00f6z Kompresyon)<\/h2>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full is-resized\"><img decoding=\"async\" width=\"840\" height=\"440\" src=\"https:\/\/kamranaghayev.com\/wp-content\/uploads\/2026\/04\/jugular-vein-compression-dementia-featured.webp\" alt=\"\" class=\"wp-image-6838\" style=\"width:600px\" srcset=\"https:\/\/kamranaghayev.com\/wp-content\/uploads\/2026\/04\/jugular-vein-compression-dementia-featured.webp 840w, https:\/\/kamranaghayev.com\/wp-content\/uploads\/2026\/04\/jugular-vein-compression-dementia-featured-300x157.webp 300w, https:\/\/kamranaghayev.com\/wp-content\/uploads\/2026\/04\/jugular-vein-compression-dementia-featured-768x402.webp 768w\" sizes=\"(max-width: 840px) 100vw, 840px\" \/><figcaption class=\"wp-element-caption\"><em>Stiloidojenik juguler ven\u00f6z kompresyon \u2013 \u0130JV (mavi) \u00f6nde stiloid \u00e7\u0131k\u0131nt\u0131, arkada C1 transvers \u00e7\u0131k\u0131nt\u0131s\u0131 aras\u0131nda s\u0131k\u0131\u015fm\u0131\u015f. Kompresyon dinamiktir: ba\u015f rotasyonu, boyun ekstansiyonu ve supin pozisyon stenozu k\u00f6t\u00fcle\u015ftirebilir \u2013 bu y\u00fczden standart supin MRV bunu \u00e7o\u011funlukla atlar.<\/em><\/figcaption><\/figure>\n\n\n\n<p>\u0130nternal juguler ven kafatas\u0131n\u0131 juguler foramenden \u00e7\u0131kar ve hemen iki sert yap\u0131 aras\u0131ndaki <strong>dar bir koridora<\/strong> girer: \u00f6nde <strong>temporal kemi\u011fin stiloid \u00e7\u0131k\u0131nt\u0131s\u0131<\/strong> ve arkada <strong>birinci servikal vertebran\u0131n (C1, atlas) transvers \u00e7\u0131k\u0131nt\u0131s\u0131<\/strong>. Baz\u0131 bireylerde bu koridor o kadar dard\u0131r ki ven mekanik olarak s\u0131k\u0131\u015f\u0131r \u2013 bu durum <strong>stiloidojenik juguler ven\u00f6z kompresyon sendromu<\/strong> olarak bilinir <sup><a href=\"#footnote_16_6928\" id=\"identifier_25_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Mejia-Vergara AJ, Sultan W, Kostas A, Mulholland CB, Sadun A. Styloidogenic Jugular Venous Compression Syndrome with Papilloedema: Case Report and Review of the Literature. Neuroophthalmology. 2021;46(1):54&ndash;58. doi:10.1080\/01658107.2021.1887288\">16<\/a><\/sup> <sup><a href=\"#footnote_17_6928\" id=\"identifier_26_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Dashti SR, Nakaji P, Hu YC, et al. Styloidogenic jugular venous compression syndrome: diagnosis and treatment: case report. Neurosurgery. 2012;70(3):E795 &ndash; E799. doi:10.1227\/NEU.0b013e3182333859\">17<\/a><\/sup> <sup><a href=\"#footnote_18_6928\" id=\"identifier_27_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Pokeerbux MR, Delmaire C, Morell-Dubois S, Demondion X, Lambert M. Styloidogenic compression of the internal jugular vein, a new venous entrapment syndrome? Vasc Med. 2020;25(4):378&ndash;380. doi:10.1177\/1358863X20902842\">18<\/a><\/sup> <sup><a href=\"#footnote_19_6928\" id=\"identifier_28_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Scerrati A, Norri N, Mongardi L, et al. Styloidogenic-cervical spondylotic internal jugular venous compression, a vascular disease related to several clinical neurological manifestations: diagnosis and treatment &ndash; a comprehensive literature review. Ann Transl Med. 2021;9(8):718. doi:10.21037\/atm-20-7698\">19<\/a><\/sup><\/p>\n\n\n\n<p>Benzetme: iki ta\u015f\u0131n aras\u0131na bast\u0131r\u0131lm\u0131\u015f bir bah\u00e7e hortumu. G\u00f6rece normal uzunlukta bir stiloid \u00e7\u0131k\u0131nt\u0131 bile, mediyal y\u00f6nde a\u00e7\u0131l\u0131 veya C1 transvers \u00e7\u0131k\u0131nt\u0131s\u0131 al\u0131\u015f\u0131lmad\u0131k bi\u00e7imde b\u00fcy\u00fck ya da lateral yerle\u015fimliyse, dramatik daralmaya yol a\u00e7abilir <sup><a href=\"#footnote_18_6928\" id=\"identifier_29_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Pokeerbux MR, Delmaire C, Morell-Dubois S, Demondion X, Lambert M. Styloidogenic compression of the internal jugular vein, a new venous entrapment syndrome? Vasc Med. 2020;25(4):378&ndash;380. doi:10.1177\/1358863X20902842\">18<\/a><\/sup> Yumu\u015fak doku katk\u0131lar\u0131 \u2013 digastrik kas, venin etraf\u0131nda ilmek yapan oksipital arter, rektus kapitis kaslar\u0131, karotis k\u0131l\u0131f\u0131 i\u00e7indeki fibr\u00f6z bantlar \u2013 t\u0131kan\u0131kl\u0131\u011f\u0131 ek olarak a\u011f\u0131rla\u015ft\u0131r\u0131r <sup><a href=\"#footnote_19_6928\" id=\"identifier_30_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Scerrati A, Norri N, Mongardi L, et al. Styloidogenic-cervical spondylotic internal jugular venous compression, a vascular disease related to several clinical neurological manifestations: diagnosis and treatment &ndash; a comprehensive literature review. Ann Transl Med. 2021;9(8):718. doi:10.21037\/atm-20-7698\">19<\/a><\/sup><\/p>\n\n\n\n<p>Bu antitenin tam anatomisi, semptomatolojisi ve cerrahi y\u00f6netimi siteye \u00f6zel bir sayfada ele al\u0131nd\u0131: <strong><a href=\"https:\/\/kamranaghayev.com\/tr\/juguler-ven-kompresyonu\/\">Juguler Ven Kompresyonu<\/a><\/strong>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">C1 kompresyonu \u0130\u0130H i\u00e7in neden \u00f6nemli<\/h3>\n\n\n\n<p>\u0130JV C1 d\u00fczeyinde s\u0131k\u0131\u015ft\u0131\u011f\u0131nda kan dural ven\u00f6z sin\u00fcslere geri biriker ve beynin ven\u00f6z bas\u0131nc\u0131 y\u00fckselir. BOS emilimi BOS ile ven\u00f6z sin\u00fcs kan\u0131 aras\u0131nda yakla\u015f\u0131k <strong>3\u20135 mmHg&#8217;l\u0131k bir bas\u0131n\u00e7 gradyan\u0131na<\/strong> ba\u011fl\u0131 oldu\u011fu i\u00e7in <sup><a href=\"#footnote_5_6928\" id=\"identifier_31_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Fargen KM, Midtlien JP, Margraf CR, Hui FK. Idiopathic intracranial hypertension pathogenesis: The jugular hypothesis. Interv Neuroradiol. 2024 Aug 8:15910199241270660. doi:10.1177\/15910199241270660\">5<\/a><\/sup> ven\u00f6z bas\u0131n\u00e7taki herhangi bir art\u0131\u015f BOS bas\u0131nc\u0131n\u0131 da telafi ama\u00e7l\u0131 y\u00fckseltir. Hastada ba\u015f a\u011fr\u0131lar\u0131, pulsatil tinnitus, papil \u00f6demi, ge\u00e7ici g\u00f6rme bulan\u0131kl\u0131klar\u0131, beyin sisi geli\u015fir \u2013 ve kendisine \u0130\u0130H tan\u0131s\u0131 konur.<\/p>\n\n\n\n<p>Birden \u00e7ok grup, juguler t\u0131kan\u0131kl\u0131\u011f\u0131n giderilmesinin dikkatle se\u00e7ilmi\u015f hastalarda intrakraniyal hipertansiyonu \u00e7\u00f6zd\u00fc\u011f\u00fcn\u00fc, a\u00e7\u0131l\u0131\u015f bas\u0131nc\u0131n\u0131n normalle\u015fti\u011fini ve belirtilerin geriledi\u011fini g\u00f6sterdi <sup><a href=\"#footnote_20_6928\" id=\"identifier_32_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Zhou D, Meng R, Zhang X, et al. Intracranial hypertension induced by internal jugular vein stenosis can be resolved by stenting. Eur J Neurol. 2018;25(2):365-e13. doi:10.1111\/ene.13512\">20<\/a><\/sup> <strong>Cerrahi dekompresyon<\/strong> \u2013 stiloid \u00e7\u0131k\u0131nt\u0131n\u0131n, C1 transvers \u00e7\u0131k\u0131nt\u0131s\u0131n\u0131n veya her ikisinin \u00e7\u0131kar\u0131lmas\u0131, varsa katk\u0131da bulunan yumu\u015fak doku kompres\u00f6rlerinin serbestle\u015ftirilmesi \u2013 en mant\u0131kl\u0131 ve kal\u0131c\u0131 yakla\u015f\u0131md\u0131r; \u00e7\u00fcnk\u00fc ger\u00e7ek mekanik nedeni ele al\u0131r, veni bask\u0131ya ra\u011fmen a\u00e7\u0131k tutmaya \u00e7al\u0131\u015fmaz.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u00c7o\u011fu klinisyenin g\u00f6zden ka\u00e7\u0131rd\u0131\u011f\u0131 ipucu: pozisyonel belirtiler<\/h3>\n\n\n\n<p>C1 d\u00fczeyindeki juguler kompresyon <strong>dinamiktir<\/strong>. Boyun hareketiyle \u015fiddetlenir ve hasta d\u00fcz yat\u0131nca da artar \u2013 \u00e7\u00fcnk\u00fc \u0130JV, supin pozisyonda beynin bask\u0131n drenaj yoludur. Uyand\u0131\u011f\u0131nda ba\u015f a\u011fr\u0131s\u0131 en \u015fiddetli olan, i\u00e7g\u00fcd\u00fcsel olarak yar\u0131 oturur durumda uyuyan, boyna manuel bas\u0131yla tinnitusu kaybolan, ba\u015f rotasyonundan sonra beyin sisi fark eden bir hasta, migren \u00f6zelli\u011fi de\u011fil mekanik \u00f6zellikler tarif ediyordur.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Kompresyon Noktas\u0131 #2: Torasik \u00c7\u0131k\u0131\u015f \u2013 Unutulmu\u015f Bir Katman<\/h2>\n\n\n\n<p>Konu\u015fman\u0131n daha ilgin\u00e7 h\u00e2le geldi\u011fi ve literat\u00fcr\u00fcn ancak son zamanlarda yeti\u015fmeye ba\u015flad\u0131\u011f\u0131 yer buras\u0131.<\/p>\n\n\n\n<p>\u0130nternal juguler ven kalbe do\u011frudan bo\u015falmaz. K\u00f6pr\u00fcc\u00fck kemi\u011finin medial ucunun arkas\u0131nda subklavyen venle birle\u015ferek <strong>brakiyosefalik (innominat) veni<\/strong> olu\u015fturur; bu ven \u00fcst mediyastinumu ge\u00e7erek superior vena kavaya girer. K\u00f6pr\u00fcc\u00fck kemi\u011fi medial ucundan VKS&#8217;a kadar uzanan t\u00fcm bu segment, <strong>torasik \u00e7\u0131k\u0131\u015ftan<\/strong> ge\u00e7er \u2013 yani <a href=\"https:\/\/kamranaghayev.com\/tr\/torasik-outlet-sendromu-nedir\/\"><strong>Torasik \u00c7\u0131k\u0131\u015f Sendromuna (TOS)<\/strong><\/a> yol a\u00e7an ayn\u0131 anatomik darbo\u011fazdan.<\/p>\n\n\n\n<p>\u00c7o\u011fu klinisyen TOS&#8217;yi brakiyal pleksus veya subklavyen arter sorunu olarak g\u00f6r\u00fcr. Bu standart \u00f6\u011freti, kendi s\u0131n\u0131rlar\u0131 i\u00e7inde do\u011frudur \u2013 <strong>n\u00f6rojenik TOS olgular\u0131n %80\u201385&#8217;ini olu\u015fturur<\/strong>. Ancak ven\u00f6z bile\u015fen, ders kitaplar\u0131n\u0131n \u00f6nerdi\u011finden \u00e7ok daha yayg\u0131n ve sonu\u00e7lar\u0131 kolun \u00e7ok \u00f6tesine uzan\u0131r.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Ekstrajuguler ven\u00f6z a\u011f<\/h3>\n\n\n\n<p>\u0130nternal juguler venler, <strong>supin<\/strong> pozisyonda beynin bask\u0131n ven\u00f6z drenaj yoludur. <strong>Dik<\/strong> pozisyonda ise \u0130JV&#8217;ler kalp seviyesinin \u00fcst\u00fcne \u00e7\u0131kar ve atmosferik bas\u0131n\u00e7 alt\u0131nda <strong>kollabe olur<\/strong>; birincil drenaj kanal\u0131 i\u015flevini yerine getirmez <sup><a href=\"#footnote_21_6928\" id=\"identifier_33_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Holmlund P, Johansson E, Qvarlander S, W&aring;hlin A, Ambarki K, Koskinen LO, Malm J, Eklund A. Human jugular vein collapse in the upright posture: implications for postural intracranial pressure regulation. Fluids Barriers CNS. 2017;14:17. doi:10.1186\/s12987-017-0065-2\">21<\/a><\/sup> Bu durumda beynin ven\u00f6z kan\u0131 alternatif bir sisteme y\u00f6nlendirilir: <strong>ekstrajuguler ven\u00f6z a\u011f (EJN)<\/strong>.<\/p>\n\n\n\n<p>EJN \u015funlar\u0131 kapsar: <strong>vertebral ven\u00f6z pleksus<\/strong> (i\u00e7 ve d\u0131\u015f), <strong>derin servikal venler<\/strong>, <strong>eksternal juguler ven<\/strong> ve <strong>arka kraniyal fossan\u0131n emisser venleri<\/strong>. Kafataban\u0131nda iki yol, <strong>Trolard&#8217;\u0131n Anterior Kondiler Konfluensi (ACC)<\/strong> \u00fczerinden anatomik olarak ba\u011flan\u0131r \u2013 hipoglossal kanal\u0131n d\u0131\u015f a\u011fz\u0131ndaki bu ven\u00f6z hub, juguler bulbu kondiler venler arac\u0131l\u0131\u011f\u0131yla do\u011frudan vertebral pleksusa ba\u011flar <sup><a href=\"#footnote_22_6928\" id=\"identifier_34_6928\" class=\"footnote-link footnote-identifier-link\" title=\"San Mill&aacute;n Ru&iacute;z D, Gailloud P, R&uuml;fenacht DA, Delavelle J, Henry F, Fasel JH. The craniocervical venous system in relation to cerebral venous drainage. AJNR Am J Neuroradiol. 2002;23(9):1500&ndash;1508.\">22<\/a><\/sup> Matematiksel modelleme ve dik pozisyon g\u00f6r\u00fcnt\u00fcleme \u00e7al\u0131\u015fmalar\u0131, dik pozisyonda vertebral pleksusun beyin ven\u00f6z kan\u0131n\u0131n <strong>bask\u0131n drenaj yolu<\/strong> h\u00e2line geldi\u011fini, \u0130JV&#8217;lerin ise k\u00fc\u00e7\u00fck bir paya sahip oldu\u011funu g\u00f6steriyor <sup><a href=\"#footnote_21_6928\" id=\"identifier_35_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Holmlund P, Johansson E, Qvarlander S, W&aring;hlin A, Ambarki K, Koskinen LO, Malm J, Eklund A. Human jugular vein collapse in the upright posture: implications for postural intracranial pressure regulation. Fluids Barriers CNS. 2017;14:17. doi:10.1186\/s12987-017-0065-2\">21<\/a><\/sup> <sup><a href=\"#footnote_23_6928\" id=\"identifier_36_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Gisolf J, van Lieshout JJ, van Heusden K, Pott F, Stok WJ, Karemaker JM. Human cerebral venous outflow pathway depends on posture and central venous pressure. J Physiol. 2004;560(Pt 1):317&ndash;327. doi:10.1113\/jphysiol.2004.070409\">23<\/a><\/sup> \u0130ki sistem, ayn\u0131 anatomik sonlanma noktas\u0131nda \u2013 <strong>boynun taban\u0131ndaki subklavyen ve brakiyosefalik venlerde<\/strong> \u2013 birle\u015fen <strong>paralel devreler<\/strong> olarak i\u015flev g\u00f6r\u00fcr.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Torasik \u00e7\u0131k\u0131\u015f sendromu beynin ven\u00f6z drenaj\u0131n\u0131 nas\u0131l a\u015f\u0131r\u0131 y\u00fckl\u00fcyor<\/h3>\n\n\n\n<p>Bu iki drenaj sisteminin boyun taban\u0131nda birle\u015fmesi, torasik \u00e7\u0131k\u0131\u015f sendromunu intrakraniyal bas\u0131nca ba\u011flayan unsurdur. Subklavyen ven kostoklavik\u00fcler birle\u015fkede kronik olarak s\u0131k\u0131\u015ft\u0131\u011f\u0131nda, \u00fcst ekstremiteden gelen kan t\u0131kanm\u0131\u015f segmentten geri d\u00f6nemez ve kollateral yollara y\u00f6nlendirilir.<\/p>\n\n\n\n<p>Sistematik g\u00f6r\u00fcnt\u00fcleme literat\u00fcr\u00fc bu kollaterallerin nereye gitti\u011fini tam olarak belgeliyor. Marini ve arkada\u015flar\u0131n\u0131n torasik kollateral \u00f6r\u00fcnt\u00fcleri \u00fczerine resimli derlemesinde, aksiller ve subklavyen t\u0131kan\u0131kl\u0131klar i\u00e7in <strong>birincil kollateral b\u00f6lge olarak servikal ven\u00f6z kanallar tan\u0131mlan\u0131r<\/strong> <sup><a href=\"#footnote_24_6928\" id=\"identifier_37_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Marini TJ, Chughtai K, Nuffer Z, Hobbs SK, Kaproth-Joslin K. Blood finds a way: pictorial review of thoracic collateral vessels. Insights Imaging. 2019;10(1):63. doi:10.1186\/s13244-019-0753-3\">24<\/a><\/sup> Ad\u0131 ge\u00e7en \u00f6n boyun yollar\u0131 aras\u0131nda <strong>internal juguler ven, eksternal juguler ven, juguler ven\u00f6z ark, inferior tiroid ven ve vertebral ven\u00f6z pleksus<\/strong> yer al\u0131r. Daha yayg\u0131n ve daha belirgin olarak tan\u0131mlanan arka boyun kollateralleri ayn\u0131 vertebral pleksustan ge\u00e7er; kar\u015f\u0131 tarafa ge\u00e7ebilir veya g\u00f6\u011f\u00fcs duvar\u0131na ve azigos sistemine bo\u015falabilir <sup><a href=\"#footnote_24_6928\" id=\"identifier_38_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Marini TJ, Chughtai K, Nuffer Z, Hobbs SK, Kaproth-Joslin K. Blood finds a way: pictorial review of thoracic collateral vessels. Insights Imaging. 2019;10(1):63. doi:10.1186\/s13244-019-0753-3\">24<\/a><\/sup><\/p>\n\n\n\n<p>Bu kollateral kanallar tam olarak beyni drene eden ekstrajuguler ven\u00f6z a\u011f\u0131 olu\u015fturan damarlard\u0131r. Ven\u00f6z TOS&#8217;li bir hastada EJN ayn\u0131 anda iki i\u015flevi yerine getirir: retrograd kollateral ak\u0131\u015f yoluyla \u00fcst ekstremiteyi ve ayn\u0131 anda beyni drene eder. Supin pozisyonda \u0130JV&#8217;ler a\u00e7\u0131kt\u0131r ve beyin ven\u00f6z d\u00f6n\u00fc\u015f\u00fcn\u00fcn \u00e7o\u011funlu\u011funu ta\u015f\u0131r; bu \u00e7ift talep tolere edilebilir. <strong>Dik pozisyonda, \u0130JV&#8217;ler kollabe oldu\u011funda ve beyin fizyolojik olarak ekstrajuguler a\u011fa ba\u011f\u0131ml\u0131 h\u00e2le geldi\u011finde, sistem a\u015f\u0131r\u0131 y\u00fcklenir.<\/strong> Beyin ven\u00f6z kan\u0131, retrograd subklavyen kollateral ak\u0131\u015fla zaten dolu kanallardan etkili bi\u00e7imde drene olamaz. Sonu\u00e7: beynin ven\u00f6z drenaj\u0131n\u0131n bozulmas\u0131, y\u00fckselen serebral ven\u00f6z bas\u0131n\u00e7 ve \u2013 bas\u0131nca ba\u011f\u0131ml\u0131 BOS emilim mekanizmas\u0131 \u00fczerinden \u2013 y\u00fckselen intrakraniyal bas\u0131n\u00e7.<\/p>\n\n\n\n<p>Bu ak\u0131\u015f y\u00f6nlendirmesi g\u00f6r\u00fcnt\u00fclemeyle do\u011frudan kayda al\u0131nd\u0131. 2017&#8217;de Chahwala ve arkada\u015flar\u0131, tek tarafl\u0131 kol \u015fi\u015fmesinin \u00f6nc\u00fcl\u00fck etti\u011fi y\u0131k\u0131c\u0131 migrenleri olan bir hastay\u0131 tan\u0131mlad\u0131. Dinamik venografide kol add\u00fcksiyonu s\u0131ras\u0131nda <strong>subklavyen vene enjekte edilen kontrast retrograd bi\u00e7imde ipsilateral internal juguler vene akt\u0131<\/strong> ve geni\u015f kollateral kanallar kan\u0131 ba\u015fa do\u011fru y\u00f6nlendirdi <sup><a href=\"#footnote_25_6928\" id=\"identifier_39_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Chahwala V, Tashiro J, Li X, Baqai A, Rey J, Robinson HR. Venous Thoracic Outlet Syndrome as a Cause of Intractable Migraines. Ann Vasc Surg. 2017;39:285.e5&ndash;285.e8. doi:10.1016\/j.avsg.2016.05.109\">25<\/a><\/sup> Hastan\u0131n migrenleri skalenektomi ve birinci kosta rezeksiyonundan sonra tamamen d\u00fczeldi. Bu olgu, kostoklavik\u00fcler ven\u00f6z t\u0131kan\u0131kl\u0131\u011f\u0131n koldan gelen ven\u00f6z d\u00f6n\u00fc\u015f\u00fc beynin drenaj yoluna zorlayabildi\u011fine dair yay\u0131mlanm\u0131\u015f literat\u00fcrdeki en do\u011frudan anjiyografik kan\u0131tt\u0131r.<\/p>\n\n\n\n<p>Rutin venografide TOS hastalar\u0131nda \u0130JV anormalliklerinin y\u00fcksek prevalans\u0131 bu fizyolojiyle uyumludur. N\u00f6rojenik TOS olan ard\u0131\u015f\u0131k hastalar\u0131n prospektif venografik \u00e7al\u0131\u015fmas\u0131nda Ahn ve arkada\u015flar\u0131, internal juguler ven stenozunu %76,2 oran\u0131nda (iki tarafl\u0131 %47,6) ve subklavyen ven stenozunu %82,5 oran\u0131nda saptad\u0131 <sup><a href=\"#footnote_26_6928\" id=\"identifier_40_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Ahn SS, Miller TJ, Chen SW, Chen JF. Internal jugular vein stenosis is common in patients presenting with neurogenic thoracic outlet syndrome. Ann Vasc Surg. 2014;28(4):946&ndash;950. doi:10.1016\/j.avsg.2013.12.009\">26<\/a><\/sup> T\u0131kanm\u0131\u015f subklavyen sistem i\u00e7in retrograd kollateral olarak g\u00f6revlendirilen bir \u0130JV, altta yatan sorun ister sabit kompresyon ister fonksiyonel konjesyon olsun, kontrast enjeksiyonunda dar ve anormal kollaterallerle \u00e7evrili g\u00f6r\u00fcnmesi beklenir.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">K\u0131rk y\u0131ll\u0131k klinik kan\u0131t \u2013 TOS cerrahisi inat\u00e7\u0131 ba\u015f a\u011fr\u0131lar\u0131n\u0131 iyile\u015ftiriyor<\/h3>\n\n\n\n<p>Torasik \u00e7\u0131k\u0131\u015f sendromunun y\u00fckselen intrakraniyal bas\u0131nca katk\u0131 sa\u011flad\u0131\u011f\u0131 arg\u00fcman\u0131 yeni de\u011fil. Asl\u0131nda k\u0131rk y\u0131ll\u0131k; ancak literat\u00fcr damar cerrahisi, n\u00f6roloji ve n\u00f6ro-oftalmoloji aras\u0131nda da\u011f\u0131lm\u0131\u015f kalm\u0131\u015f ve hen\u00fcz hak etti\u011fi \u00e7er\u00e7eveye sentezlenmemi\u015f.<\/p>\n\n\n\n<p><strong>1985&#8217;te<\/strong> Raskin, Howard ve Ehrenfeld, transaksillar birinci kosta rezeksiyonu sonras\u0131 en az alt\u0131 ay boyunca otuz ard\u0131\u015f\u0131k TOS hastas\u0131n\u0131 izledi. Otuzun yirmi alt\u0131s\u0131nda tekrarlayan ba\u015f a\u011fr\u0131s\u0131, boyun ve omuz a\u011fr\u0131s\u0131n\u0131n ortaya \u00e7\u0131k\u0131\u015f\u0131ndan <em>\u00f6nce<\/em> mevcuttu. Cerrahi sonras\u0131 <strong>on \u00fc\u00e7 hasta tamamen ba\u015f a\u011fr\u0131s\u0131z h\u00e2le geldi, daha \u00f6nce \u00e7al\u0131\u015famayacak durumdaki on bir hasta i\u015fine geri d\u00f6nd\u00fc ve ek olarak on bir hasta cerrahi \u00f6ncesinde etkisiz olan vazoaktif ila\u00e7lara yeni yan\u0131t geli\u015ftirdi\u011fini bildirdi<\/strong> <sup><a href=\"#footnote_27_6928\" id=\"identifier_41_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Raskin NH, Howard MW, Ehrenfeld WK. Headache as the leading symptom of the thoracic outlet syndrome. Headache. 1985;25(4):208&ndash;210. doi:10.1111\/j.1526-4610.1985.hed2504208.x\">27<\/a><\/sup> O zaman mekanizma belirsiz \u00abvask\u00fcler fakt\u00f6rlere\u00bb atfedildi. Bug\u00fcn bu fakt\u00f6rlerin nas\u0131l g\u00f6r\u00fcnd\u00fc\u011f\u00fcne dair \u00e7ok daha net bir anjiyografik tablomuz var \u2013 yukar\u0131da anlat\u0131lan Chahwala&#8217;n\u0131n 2017 olgusunun g\u00f6sterdi\u011fi gibi.<\/p>\n\n\n\n<p>En g\u00fcncel ve en b\u00fcy\u00fck seri <strong>Cha ve arkada\u015flar\u0131 taraf\u0131ndan 2025&#8217;te<\/strong> <em>Clinical Anatomy<\/em> dergisinde yay\u0131mland\u0131; kronik migren ve TOS \u00e7ift tan\u0131s\u0131 ta\u015f\u0131yan elli ard\u0131\u015f\u0131k hasta incelendi <sup><a href=\"#footnote_28_6928\" id=\"identifier_42_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Cha YH, Randall L, Weber J, Ahn S. Treatment of thoracic outlet syndrome to relieve chronic migraine. Clin Anat. 2025;38(3):314&ndash;323. doi:10.1002\/ca.24242\">28<\/a><\/sup> Klinik \u00f6zellikler ayd\u0131nlat\u0131c\u0131yd\u0131:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Hastalar\u0131n <strong>%76&#8217;s\u0131nda ba\u015f a\u011fr\u0131lar\u0131 yana kilitliydi veya TOS&#8217;li uzuvla ayn\u0131 tarafta daha \u015fiddetliydi<\/strong><\/li>\n\n\n\n<li><strong>%67&#8217;sinde<\/strong> ekstremite \u015fi\u015fli\u011fi e\u015flik ediyordu<\/li>\n\n\n\n<li>En tan\u0131sal de\u011feri olan ipucu olarak \u2013 <strong>%84&#8217;\u00fc yatar pozisyonda ba\u015f a\u011fr\u0131s\u0131n\u0131n k\u00f6t\u00fcle\u015fti\u011fini<\/strong> bildirdi; uyku s\u0131ras\u0131nda intrakraniyal drenaj\u0131n giderek juguler yola ba\u011f\u0131ml\u0131 h\u00e2le geldi\u011fi ko\u015fullarda tam olarak beklenen \u00f6r\u00fcnt\u00fc<\/li>\n<\/ul>\n\n\n\n<p>Elli hastan\u0131n otuz ikisine cerrahi dekompresyon uyguland\u0131 ve ba\u015f a\u011fr\u0131s\u0131 y\u00fck\u00fcnde belirgin iyile\u015fme sa\u011fland\u0131 <sup><a href=\"#footnote_28_6928\" id=\"identifier_43_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Cha YH, Randall L, Weber J, Ahn S. Treatment of thoracic outlet syndrome to relieve chronic migraine. Clin Anat. 2025;38(3):314&ndash;323. doi:10.1002\/ca.24242\">28<\/a><\/sup> Yatar pozisyonda k\u00f6t\u00fcle\u015fme, beynin ven\u00f6z drenaj\u0131ndaki bozuklu\u011fun ba\u015fucu parmak izidir. Hastalar ba\u015f a\u011fr\u0131s\u0131yla uyand\u0131klar\u0131n\u0131, i\u00e7g\u00fcd\u00fcsel olarak yar\u0131 oturur durumda uyuduklar\u0131n\u0131 ve ba\u015f y\u00fckseltmenin ila\u00e7tan daha fazla rahatlama sa\u011flad\u0131\u011f\u0131n\u0131 anlat\u0131r.<\/p>\n\n\n\n<p>Par\u00e7alar, k\u0131rk y\u0131l\u0131 kapsayan tutarl\u0131 bir hik\u00e2yeye uyuyor. <strong>Raskin&#8217;in 1985 klinik g\u00f6zlemi<\/strong> \u2013 birinci kosta rezeksiyonundan sonra ba\u015f a\u011fr\u0131lar\u0131n\u0131n d\u00fczelmesi <sup><a href=\"#footnote_27_6928\" id=\"identifier_44_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Raskin NH, Howard MW, Ehrenfeld WK. Headache as the leading symptom of the thoracic outlet syndrome. Headache. 1985;25(4):208&ndash;210. doi:10.1111\/j.1526-4610.1985.hed2504208.x\">27<\/a><\/sup> <strong>Ahn&#8217;\u0131n 2014 anatomik kan\u0131t\u0131<\/strong> \u2013 nTOS hastalar\u0131n\u0131n %76&#8217;s\u0131n\u0131n \u0130JV stenozu ta\u015f\u0131d\u0131\u011f\u0131 <sup><a href=\"#footnote_26_6928\" id=\"identifier_45_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Ahn SS, Miller TJ, Chen SW, Chen JF. Internal jugular vein stenosis is common in patients presenting with neurogenic thoracic outlet syndrome. Ann Vasc Surg. 2014;28(4):946&ndash;950. doi:10.1016\/j.avsg.2013.12.009\">26<\/a><\/sup> <strong>Chahwala&#8217;n\u0131n 2017 anjiyografik g\u00f6sterimi<\/strong> \u2013 TOS d\u00fczeyindeki bir t\u0131kan\u0131kl\u0131ktan beynin ven\u00f6z sistemine retrograd ak\u0131\u015f <sup><a href=\"#footnote_25_6928\" id=\"identifier_46_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Chahwala V, Tashiro J, Li X, Baqai A, Rey J, Robinson HR. Venous Thoracic Outlet Syndrome as a Cause of Intractable Migraines. Ann Vasc Surg. 2017;39:285.e5&ndash;285.e8. doi:10.1016\/j.avsg.2016.05.109\">25<\/a><\/sup> <strong>Cha&#8217;n\u0131n 2025 modern olgu serisi<\/strong> \u2013 elli hastada ba\u015fucu \u00f6zelliklerinin ve cerrahi yan\u0131t\u0131n belgelenmesi <sup><a href=\"#footnote_28_6928\" id=\"identifier_47_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Cha YH, Randall L, Weber J, Ahn S. Treatment of thoracic outlet syndrome to relieve chronic migraine. Clin Anat. 2025;38(3):314&ndash;323. doi:10.1002\/ca.24242\">28<\/a><\/sup> Her biri farkl\u0131 bir uzmanl\u0131k dergisinde yay\u0131mland\u0131 ve alan hen\u00fcz aralar\u0131ndaki sentezi yapmad\u0131. Bu sentez, mevcut yaz\u0131n\u0131n yapmaya \u00e7al\u0131\u015ft\u0131\u011f\u0131 \u015feydir.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Sentez: Beynin \u0130ki D\u00fczeyli Ven\u00f6z Drenaj Modeli<\/h2>\n\n\n\n<p>\u0130\u0130H, <strong>bozulmu\u015f ven\u00f6z drenaj hastal\u0131\u011f\u0131<\/strong> olarak yeniden \u00e7er\u00e7evelendi\u011finde klinik tablo belirgin bi\u00e7imde berrakla\u015f\u0131r. Beynin ven\u00f6z kan\u0131 bir dizi darbo\u011faz\u0131 s\u0131rayla ge\u00e7mek zorundad\u0131r:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Dural sin\u00fcslerden <strong>juguler foramene<\/strong><\/li>\n\n\n\n<li><strong>Stiloid \u2013 C1 koridorundan<\/strong> ge\u00e7erek (kompresyon noktas\u0131 1)<\/li>\n\n\n\n<li>C3 \u2013 C6 d\u00fczeyindeki dinamik kas ve karotis ili\u015fkilerinin i\u00e7inden<\/li>\n\n\n\n<li><strong>Torasik \u00e7\u0131k\u0131\u015ftaki kostoklavik\u00fcler alandan<\/strong> (kompresyon noktas\u0131 2)<\/li>\n\n\n\n<li>Brakiyosefalik ven ve VKS yoluyla sa\u011f atriyuma<\/li>\n<\/ol>\n\n\n\n<p>Bu d\u00fczeylerden herhangi birindeki bir darbo\u011faz, ak\u0131\u015f yukar\u0131s\u0131nda bas\u0131nc\u0131 y\u00fckseltir; birden fazla d\u00fczeydeki darbo\u011fazlar ise sorunu birikimli olarak a\u011f\u0131rla\u015ft\u0131r\u0131r. Sistem <strong>dinamik<\/strong> oldu\u011fu i\u00e7in \u2013 ba\u015f pozisyonu, kol pozisyonu, solunum ve post\u00fcrden etkilendi\u011fi i\u00e7in \u2013 supin pozisyondaki statik standart g\u00f6r\u00fcnt\u00fcleme bu \u00fcst \u00fcste binmi\u015f t\u0131kan\u0131kl\u0131klar\u0131 d\u00fczenli olarak ka\u00e7\u0131r\u0131r.<\/p>\n\n\n\n<p>Bu model, \u0130\u0130H prati\u011findeki en s\u0131k\u0131nt\u0131 verici g\u00f6zlemlerin baz\u0131lar\u0131n\u0131 a\u00e7\u0131klar:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>BOS y\u00f6nlendirme prosed\u00fcrlerinin ve bas\u0131n\u00e7 d\u00fc\u015f\u00fcr\u00fcc\u00fc ila\u00e7lar\u0131n neden \u00e7o\u011fu zaman yaln\u0131zca ge\u00e7ici rahatlama sa\u011flad\u0131\u011f\u0131 \u2013 ak\u0131\u015f yukar\u0131s\u0131ndaki mekanik t\u0131kan\u0131kl\u0131\u011fa m\u00fcdahale etmiyorlar<\/li>\n\n\n\n<li>Baz\u0131 hastalar\u0131n kilo kayb\u0131ndan sonra neden n\u00fcks etti\u011fi (mekanik t\u0131kan\u0131kl\u0131k VK\u0130&#8217;den etkilenmez)<\/li>\n\n\n\n<li>\u00ab\u0130diyopatik\u00bb intrakraniyal hipertansiyonun TOS, Eagle sendromu, POTS, Ehlers \u2013 Danlos sendromu ve spontan BOS ka\u00e7a\u011f\u0131 fenotipleriyle neden bu kadar yo\u011fun \u00f6rt\u00fc\u015ft\u00fc\u011f\u00fc <sup><a href=\"#footnote_29_6928\" id=\"identifier_48_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Midtlien JP, Curry BP, Chang E, et al. Characterizing a new clinical phenotype: the co-existence of cerebral venous outflow and connective tissue disorders. Front Neurol. 2023;14:1305972. doi:10.3389\/fneur.2023.1305972\">29<\/a><\/sup> <sup><a href=\"#footnote_30_6928\" id=\"identifier_49_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Manupipatpong S, Primiani CT, Fargen KM, et al. Jugular venous narrowing and spontaneous spinal cerebrospinal fluid leaks: A case &ndash; control study exploring association and proposed mechanism. Interv Neuroradiol. 2024;30(6):812&ndash;818. doi:10.1177\/15910199241287417\">30<\/a><\/sup><\/li>\n\n\n\n<li>Kollaterallerin k\u0131smen telafi etti\u011fi durumlarda (IIHWOP) papil \u00f6deminin neden olmayabildi\u011fi <sup><a href=\"#footnote_8_6928\" id=\"identifier_50_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Mollan SP, Aguiar M, Evison F, Frew E, Sinclair AJ. The expanding burden of idiopathic intracranial hypertension. Eye (Lond). 2019;33(3):478&ndash;485. doi:10.1038\/s41433-018-0238-5\">8<\/a><\/sup><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Tan\u0131sal sonu\u00e7lar \u2013 neyin g\u00f6r\u00fcnt\u00fclenmesi gerekiyor<\/h2>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full is-resized\"><img decoding=\"async\" width=\"800\" height=\"450\" src=\"https:\/\/kamranaghayev.com\/wp-content\/uploads\/2026\/05\/styloid-process.webp\" alt=\"\" class=\"wp-image-6869\" style=\"width:600px\" srcset=\"https:\/\/kamranaghayev.com\/wp-content\/uploads\/2026\/05\/styloid-process.webp 800w, https:\/\/kamranaghayev.com\/wp-content\/uploads\/2026\/05\/styloid-process-300x169.webp 300w, https:\/\/kamranaghayev.com\/wp-content\/uploads\/2026\/05\/styloid-process-768x432.webp 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\"><em>Stiloid \u00e7\u0131k\u0131nt\u0131 \u2013 temporal kemikten inen ince bir kemiksi uzant\u0131. Stiloidojenik \u0130JV kompresyonu \u015f\u00fcphesinde, ba\u015f-boyun BT&#8217;sinde uzunlu\u011fu, a\u00e7\u0131lanmas\u0131 ve stilohyoid ligaman\u0131n ossifikasyonu en eyleme y\u00f6nelik bulgulard\u0131r.<\/em><\/figcaption><\/figure>\n\n\n\n<p>Hasta \u0130\u0130H fenotipiyle ba\u015fvuruyorsa, de\u011ferlendirme beyin MR&#8217;\u0131 ve lomber ponksiyonla durmamal\u0131d\u0131r. Tam ven\u00f6z drenaj de\u011ferlendirmesi \u015funlar\u0131 i\u00e7ermelidir:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Ba\u015f ve boynun BT venografisi (BTV)<\/strong> \u2013 stiloid \u2013 C1 koridorunu g\u00f6rselle\u015ftirmenin ve juguler stenozu say\u0131salla\u015ft\u0131rman\u0131n g\u00fcn\u00fcm\u00fcz alt\u0131n standard\u0131 <sup><a href=\"#footnote_16_6928\" id=\"identifier_51_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Mejia-Vergara AJ, Sultan W, Kostas A, Mulholland CB, Sadun A. Styloidogenic Jugular Venous Compression Syndrome with Papilloedema: Case Report and Review of the Literature. Neuroophthalmology. 2021;46(1):54&ndash;58. doi:10.1080\/01658107.2021.1887288\">16<\/a><\/sup> <sup><a href=\"#footnote_17_6928\" id=\"identifier_52_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Dashti SR, Nakaji P, Hu YC, et al. Styloidogenic jugular venous compression syndrome: diagnosis and treatment: case report. Neurosurgery. 2012;70(3):E795 &ndash; E799. doi:10.1227\/NEU.0b013e3182333859\">17<\/a><\/sup><\/li>\n\n\n\n<li><strong>MR venografisi (MRV)<\/strong> \u2013 ak\u0131\u015f paterni ve kollateral de\u011ferlendirmesi i\u00e7in yararl\u0131 <sup><a href=\"#footnote_5_6928\" id=\"identifier_53_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Fargen KM, Midtlien JP, Margraf CR, Hui FK. Idiopathic intracranial hypertension pathogenesis: The jugular hypothesis. Interv Neuroradiol. 2024 Aug 8:15910199241270660. doi:10.1177\/15910199241270660\">5<\/a><\/sup><\/li>\n\n\n\n<li><strong>Dinamik g\u00f6r\u00fcnt\u00fcleme<\/strong> \u2013 farkl\u0131 ba\u015f pozisyonlar\u0131nda ve m\u00fcmk\u00fcnse dik pozisyonda g\u00f6r\u00fcnt\u00fcleme; statik supin g\u00f6r\u00fcnt\u00fcler dinamik stenozu oldu\u011fundan az g\u00f6sterir <sup><a href=\"#footnote_5_6928\" id=\"identifier_54_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Fargen KM, Midtlien JP, Margraf CR, Hui FK. Idiopathic intracranial hypertension pathogenesis: The jugular hypothesis. Interv Neuroradiol. 2024 Aug 8:15910199241270660. doi:10.1177\/15910199241270660\">5<\/a><\/sup><\/li>\n\n\n\n<li><strong>Bas\u0131n\u00e7 \u00f6l\u00e7\u00fcml\u00fc kateter venografisi<\/strong> \u2013 trans-stenotik gradiyentleri say\u0131salla\u015ft\u0131rman\u0131n tek g\u00fcvenilir yolu; stenoz boyunca &gt;3\u20135 mmHg gradiyent klinik olarak anlaml\u0131d\u0131r <sup><a href=\"#footnote_20_6928\" id=\"identifier_55_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Zhou D, Meng R, Zhang X, et al. Intracranial hypertension induced by internal jugular vein stenosis can be resolved by stenting. Eur J Neurol. 2018;25(2):365-e13. doi:10.1111\/ene.13512\">20<\/a><\/sup><\/li>\n\n\n\n<li><strong>Brakiyosefalik ve subklavyen venografi<\/strong> \u2013 \u00f6zellikle hastada herhangi bir kol belirtisi, TOS&#8217;nin klinik \u00f6zellikleri varsa veya ak\u0131\u015f yukar\u0131s\u0131ndaki m\u00fcdahalelere yan\u0131t vermemi\u015fse <sup><a href=\"#footnote_26_6928\" id=\"identifier_56_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Ahn SS, Miller TJ, Chen SW, Chen JF. Internal jugular vein stenosis is common in patients presenting with neurogenic thoracic outlet syndrome. Ann Vasc Surg. 2014;28(4):946&ndash;950. doi:10.1016\/j.avsg.2013.12.009\">26<\/a><\/sup><\/li>\n\n\n\n<li><strong>Provokatif manevralar<\/strong> \u2013 kollar yukar\u0131da MRV\/MRA, istirahat g\u00f6r\u00fcnt\u00fclemesinin ka\u00e7\u0131rd\u0131\u011f\u0131 kostoklavik\u00fcler ven\u00f6z kompresyonu a\u00e7\u0131\u011fa \u00e7\u0131karabilir<\/li>\n<\/ul>\n\n\n\n<p>Ayr\u0131nt\u0131l\u0131 bir \u00f6yk\u00fc, g\u00f6r\u00fcnt\u00fcleme kadar \u00f6nemlidir. <strong>Pozisyonel ba\u015f a\u011fr\u0131lar\u0131, ba\u015f rotasyonuyla tetiklenen tinnitus, boyunda bask\u0131 hissi, kol belirtileri, eforla beyin sisi, yatar pozisyonda ba\u015f a\u011fr\u0131s\u0131n\u0131n k\u00f6t\u00fcle\u015fmesi ve ki\u015fisel veya ailesel hipermobilite \u00f6yk\u00fcs\u00fc<\/strong> \u2013 t\u00fcm bu \u00f6zellikler ay\u0131r\u0131c\u0131 tan\u0131y\u0131 mekanik bir ven\u00f6z drenaj sorunu y\u00f6n\u00fcne \u00e7eker.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Tedavi sonu\u00e7lar\u0131<\/h2>\n\n\n\n<p>Tedavi nedene uygun olmal\u0131d\u0131r. Ven\u00f6z drenaj modelinden birka\u00e7 ilke \u00e7\u0131kar:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Asetazolamid ve kilo kayb\u0131<\/strong> s\u0131ras\u0131yla BOS \u00fcretimini ve santral ven\u00f6z bas\u0131nc\u0131 d\u00fc\u015f\u00fcr\u00fcr. Yard\u0131mc\u0131 olur, ancak mekanik t\u0131kan\u0131kl\u0131\u011f\u0131 \u00e7\u00f6zmez.<\/li>\n\n\n\n<li><strong>Lomboperitoneal ve ventrik\u00fcloperitoneal \u015fantlar<\/strong> belirtiyi (y\u00fcksek BOS bas\u0131nc\u0131) ele al\u0131r, nedeni ele almaz. Uzun vadeli ba\u015far\u0131s\u0131zl\u0131k oranlar\u0131 y\u00fcksektir.<\/li>\n\n\n\n<li><strong>Stilojenik \u0130JV kompresyonu i\u00e7in cerrahi dekompresyon<\/strong> \u2013 stiloid \u00e7\u0131k\u0131nt\u0131n\u0131n, C1 transvers \u00e7\u0131k\u0131nt\u0131s\u0131n\u0131n veya her ikisinin \u00e7\u0131kar\u0131lmas\u0131, varsa yumu\u015fak doku kompres\u00f6rlerinin serbestle\u015ftirilmesi \u2013 ak\u0131\u015f yukar\u0131s\u0131ndaki nedeni do\u011frudan ele al\u0131r. Se\u00e7ilmi\u015f olgu serilerinde intrakraniyal bas\u0131nc\u0131n normalle\u015fti\u011fi ve papil \u00f6deminin geriledi\u011fi g\u00f6sterildi <sup><a href=\"#footnote_16_6928\" id=\"identifier_57_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Mejia-Vergara AJ, Sultan W, Kostas A, Mulholland CB, Sadun A. Styloidogenic Jugular Venous Compression Syndrome with Papilloedema: Case Report and Review of the Literature. Neuroophthalmology. 2021;46(1):54&ndash;58. doi:10.1080\/01658107.2021.1887288\">16<\/a><\/sup> <sup><a href=\"#footnote_20_6928\" id=\"identifier_58_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Zhou D, Meng R, Zhang X, et al. Intracranial hypertension induced by internal jugular vein stenosis can be resolved by stenting. Eur J Neurol. 2018;25(2):365-e13. doi:10.1111\/ene.13512\">20<\/a><\/sup> Tedavi \u00f6zeti <strong><a href=\"https:\/\/kamranaghayev.com\/tr\/juguler-ven-kompresyonu-tedavisi\/\">Juguler Ven Kompresyonu Tedavisi<\/a><\/strong> sayfas\u0131nda yer al\u0131yor.<\/li>\n\n\n\n<li><strong>Birinci kosta rezeksiyonu ve torasik \u00e7\u0131k\u0131\u015f dekompresyonu<\/strong>, kostoklavik\u00fcler alan\u0131n s\u0131n\u0131rlay\u0131c\u0131 darbo\u011faz oldu\u011fu durumlarda ak\u0131\u015f a\u015fa\u011f\u0131s\u0131ndaki bile\u015feni ele al\u0131r. K\u0131rk y\u0131ll\u0131k klinik veri \u2013 Raskin&#8217;in 1985 orijinal serisinden Cha&#8217;n\u0131n 2025 olgu serisine kadar \u2013 uygun \u015fekilde se\u00e7ilmi\u015f hastalarda bu prosed\u00fcrden sonra ba\u015f a\u011fr\u0131s\u0131nda belirgin iyile\u015fme oldu\u011funu belgeliyor <sup><a href=\"#footnote_27_6928\" id=\"identifier_59_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Raskin NH, Howard MW, Ehrenfeld WK. Headache as the leading symptom of the thoracic outlet syndrome. Headache. 1985;25(4):208&ndash;210. doi:10.1111\/j.1526-4610.1985.hed2504208.x\">27<\/a><\/sup> <sup><a href=\"#footnote_28_6928\" id=\"identifier_60_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Cha YH, Randall L, Weber J, Ahn S. Treatment of thoracic outlet syndrome to relieve chronic migraine. Clin Anat. 2025;38(3):314&ndash;323. doi:10.1002\/ca.24242\">28<\/a><\/sup> Geli\u015ftirdi\u011fim <strong><a href=\"https:\/\/kamranaghayev.com\/tr\/torasik-outlet-sendromu-pure-teknigi\/\">PURED prosed\u00fcr\u00fc<\/a><\/strong> birinci kostan\u0131n posterior yakla\u015f\u0131mla tam rezeksiyonuna olanak verir; geleneksel supraklavik\u00fcler veya transaksillar yakla\u015f\u0131mlara k\u0131yasla ven\u00f6z ve sinir yap\u0131lar\u0131na \u00f6nemli \u00f6l\u00e7\u00fcde daha iyi eri\u015fim sa\u011flar.<\/li>\n\n\n\n<li><strong>Ard\u0131\u015f\u0131k a\u015famal\u0131 dekompresyon<\/strong> \u00fcst \u00fcste binmi\u015f kompresyonlar\u0131 olan hastalarda gerekli olabilir. \u0130lke, damar cerrahisinin genel ilkesiyle ayn\u0131d\u0131r: \u00f6nce hemodinamik olarak en anlaml\u0131 lezyonu ele al, ard\u0131ndan durumu yeniden de\u011ferlendir ve sonrakine ge\u00e7.<\/li>\n<\/ul>\n\n\n\n<p>Her \u0130\u0130H hastas\u0131n\u0131n ameliyata ihtiyac\u0131 yok. Ancak her \u0130\u0130H hastas\u0131, varsa mekanik bir nedeni saptayabilecek bir de\u011ferlendirmeyi hak ediyor \u2013 ve \u00f6nemli bir k\u0131sm\u0131nda bu neden var.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">\u0130\u0130H De\u011ferlendirmesini Yeniden \u00c7er\u00e7evelemek<\/h2>\n\n\n\n<p>\u00ab\u0130diyopatik intrakraniyal hipertansiyon\u00bb etiketi tam olarak ne ise \u00f6yle anla\u015f\u0131lmal\u0131d\u0131r: standart de\u011ferlendirmenin s\u0131n\u0131rlar\u0131n\u0131 yans\u0131tan <strong>ge\u00e7ici bir etiket<\/strong>, kesin bir tan\u0131 de\u011fil. Ven\u00f6z drenaj trakt\u0131 dikkatle incelendi\u011finde \u2013 juguler foramenden, C1 koridorundan, dinamik orta servikal seyirden ve torasik \u00e7\u0131k\u0131\u015ftan ge\u00e7erek \u2013 hastalar\u0131n \u00f6nemli bir k\u0131sm\u0131nda mekanik bir neden saptanabiliyor <sup><a href=\"#footnote_5_6928\" id=\"identifier_61_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Fargen KM, Midtlien JP, Margraf CR, Hui FK. Idiopathic intracranial hypertension pathogenesis: The jugular hypothesis. Interv Neuroradiol. 2024 Aug 8:15910199241270660. doi:10.1177\/15910199241270660\">5<\/a><\/sup> <sup><a href=\"#footnote_20_6928\" id=\"identifier_62_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Zhou D, Meng R, Zhang X, et al. Intracranial hypertension induced by internal jugular vein stenosis can be resolved by stenting. Eur J Neurol. 2018;25(2):365-e13. doi:10.1111\/ene.13512\">20<\/a><\/sup> <sup><a href=\"#footnote_26_6928\" id=\"identifier_63_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Ahn SS, Miller TJ, Chen SW, Chen JF. Internal jugular vein stenosis is common in patients presenting with neurogenic thoracic outlet syndrome. Ann Vasc Surg. 2014;28(4):946&ndash;950. doi:10.1016\/j.avsg.2013.12.009\">26<\/a><\/sup><\/p>\n\n\n\n<p>C1 d\u00fczeyindeki juguler ven kompresyonu ve torasik \u00e7\u0131k\u0131\u015f sendromu, en s\u0131k g\u00f6zden ka\u00e7an iki katk\u0131dad\u0131r. Ortak bir hasta fenotipi payla\u015f\u0131rlar, s\u0131kl\u0131kla bir arada bulunurlar ve \u00abklasik\u00bb \u0130\u0130H&#8217;den ay\u0131rt edilemez bir klinik tablo olu\u015ftururlar. Mekanistik arg\u00fcman art\u0131k spek\u00fclasyon alan\u0131nda de\u011fil: Ahn&#8217;\u0131n anatomik \u00e7al\u0131\u015fmas\u0131 nTOS hastalar\u0131n\u0131n d\u00f6rtte \u00fc\u00e7\u00fcnde torasik \u00e7\u0131k\u0131\u015ftaki \u0130JV stenozunu belgeliyor <sup><a href=\"#footnote_26_6928\" id=\"identifier_64_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Ahn SS, Miller TJ, Chen SW, Chen JF. Internal jugular vein stenosis is common in patients presenting with neurogenic thoracic outlet syndrome. Ann Vasc Surg. 2014;28(4):946&ndash;950. doi:10.1016\/j.avsg.2013.12.009\">26<\/a><\/sup> Chahwala&#8217;n\u0131n olgusu beynin ven\u00f6z sistemine retrograd ak\u0131\u015f\u0131 ger\u00e7ek zamanl\u0131 venografide g\u00f6steriyor <sup><a href=\"#footnote_25_6928\" id=\"identifier_65_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Chahwala V, Tashiro J, Li X, Baqai A, Rey J, Robinson HR. Venous Thoracic Outlet Syndrome as a Cause of Intractable Migraines. Ann Vasc Surg. 2017;39:285.e5&ndash;285.e8. doi:10.1016\/j.avsg.2016.05.109\">25<\/a><\/sup> ve k\u0131rk y\u0131ll\u0131k cerrahi kan\u0131t \u2013 Raskin&#8217;den Cha&#8217;ya \u2013 torasik \u00e7\u0131k\u0131\u015f dekompresyonunun bunlardan kaynaklanan ba\u015f a\u011fr\u0131lar\u0131n\u0131 rahatlatt\u0131\u011f\u0131n\u0131 belgeliyor <sup><a href=\"#footnote_27_6928\" id=\"identifier_66_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Raskin NH, Howard MW, Ehrenfeld WK. Headache as the leading symptom of the thoracic outlet syndrome. Headache. 1985;25(4):208&ndash;210. doi:10.1111\/j.1526-4610.1985.hed2504208.x\">27<\/a><\/sup> <sup><a href=\"#footnote_28_6928\" id=\"identifier_67_6928\" class=\"footnote-link footnote-identifier-link\" title=\"Cha YH, Randall L, Weber J, Ahn S. Treatment of thoracic outlet syndrome to relieve chronic migraine. Clin Anat. 2025;38(3):314&ndash;323. doi:10.1002\/ca.24242\">28<\/a><\/sup> Bu hastalar\u0131 tan\u0131mak, kafatas\u0131n\u0131n \u00f6tesine bakma ve ven\u00f6z drenaj trakt\u0131n\u0131 dinamik bi\u00e7imde g\u00f6r\u00fcnt\u00fcleme iste\u011fini gerektiriyor. Tedavileri ise n\u00f6ro\u015firurji, damar cerrahisi ve n\u00f6rogiri\u015fimsel uzmanl\u0131\u011f\u0131 birle\u015ftiren bir uzmanl\u0131k zinciri gerektiriyor \u2013 klini\u011fimizin tam \u00fczerine kuruldu\u011fu multidisipliner yakla\u015f\u0131m.<\/p>\n\n\n\n<p>Size \u0130\u0130H tan\u0131s\u0131 konulduysa, belirtileriniz d\u00fczelmiyorsa ve hen\u00fcz kimse juguler venlerinizi veya torasik \u00e7\u0131k\u0131\u015f\u0131n\u0131z\u0131 g\u00f6r\u00fcnt\u00fclemediyse \u2013 bu konu\u015fmay\u0131 ba\u015flatmaya de\u011fer.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Sonraki yaz\u0131<\/h2>\n\n\n\n<p><strong><a href=\"https:\/\/kamranaghayev.com\/tr\/juguler-ven-kompresyonu\/\">Juguler Ven Kompresyonu: Ayr\u0131nt\u0131l\u0131 \u0130nceleme<\/a><\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Ayr\u0131ca bak\u0131n\u0131z<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong><a href=\"https:\/\/kamranaghayev.com\/tr\/torasik-outlet-sendromu-nedir\/\">Torasik \u00c7\u0131k\u0131\u015f Sendromu Nedir?<\/a><\/strong><\/li>\n\n\n\n<li><strong><a href=\"https:\/\/kamranaghayev.com\/tr\/eagle-sendromu\/\">Eagle Sendromu<\/a><\/strong><\/li>\n\n\n\n<li><strong><a href=\"https:\/\/kamranaghayev.com\/tr\/torasik-outlet-sendromu-pure-teknigi\/\">Torasik \u00c7\u0131k\u0131\u015f Sendromu i\u00e7in PURED Prosed\u00fcr\u00fc<\/a><\/strong><\/li>\n\n\n\n<li><strong><a href=\"https:\/\/kamranaghayev.com\/tr\/juguler-ven-kompresyonu-tedavisi\/\">Juguler Ven Kompresyonu Tedavisi<\/a><\/strong><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Kaynaklar<\/h2>\n<ol class=\"footnotes\"><li id=\"footnote_1_6928\" class=\"footnote\">Friedman DI, Liu GT, Digre KB. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. <em>Neurology<\/em>. 2013;81(13):1159\u20131165. doi:10.1212\/WNL.0b013e3182a55f17<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_1_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_8_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_2_6928\" class=\"footnote\">Markey KA, Mollan SP, Jensen RH, Sinclair AJ. Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions. <em>Lancet Neurol<\/em>. 2016;15(1):78\u201391. doi:10.1016\/S1474-4422(15)00298-7<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_2_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_11_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_3_6928\" class=\"footnote\">Mollan SP, Davies B, Silver NC, et al. Idiopathic intracranial hypertension: consensus guidelines on management. <em>J Neurol Neurosurg Psychiatry<\/em>. 2018;89(10):1088\u20131100. doi:10.1136\/jnnp-2017-317440<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_3_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_9_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_10_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_12_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_4_6928\" class=\"footnote\">Wall M, Kupersmith MJ, Kieburtz KD, et al. The Idiopathic Intracranial Hypertension Treatment Trial: clinical profile at baseline. <em>JAMA Neurol<\/em>. 2014;71(6):693\u2013701. doi:10.1001\/jamaneurol.2014.133<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_4_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_5_6928\" class=\"footnote\">Fargen KM, Midtlien JP, Margraf CR, Hui FK. Idiopathic intracranial hypertension pathogenesis: The jugular hypothesis. <em>Interv Neuroradiol<\/em>. 2024 Aug 8:15910199241270660. doi:10.1177\/15910199241270660<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_5_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_13_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_15_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_16_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_24_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_31_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_53_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_54_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_61_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_6_6928\" class=\"footnote\">Townsend RK, Fargen KM. Intracranial venous hypertension and venous sinus stenting in the modern management of idiopathic intracranial hypertension. <em>Life (Basel)<\/em>. 2021;11(6):508. doi:10.3390\/life11060508<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_6_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_7_6928\" class=\"footnote\">Bono F, Messina D, Giliberto C, et al. Bilateral transverse sinus stenosis predicts IIH without papilledema in patients with migraine. <em>Neurology<\/em>. 2006;67(3):419\u2013423. doi:10.1212\/01.wnl.0000227892.67354.85<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_7_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_8_6928\" class=\"footnote\">Mollan SP, Aguiar M, Evison F, Frew E, Sinclair AJ. The expanding burden of idiopathic intracranial hypertension. <em>Eye (Lond)<\/em>. 2019;33(3):478\u2013485. doi:10.1038\/s41433-018-0238-5<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_14_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_50_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_9_6928\" class=\"footnote\">Corbett JJ, Digre K. Idiopathic intracranial hypertension: an answer to &#8220;the chicken or the egg?&#8221; <em>Neurology<\/em>. 2002;58(1):5\u20136. doi:10.1212\/wnl.58.1.5<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_17_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_10_6928\" class=\"footnote\">King JO, Mitchell PJ, Thomson KR, Tress BM. Manometry combined with cervical puncture in idiopathic intracranial hypertension. <em>Neurology<\/em>. 2002;58(1):26\u201330. doi:10.1212\/wnl.58.1.26<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_18_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_11_6928\" class=\"footnote\">Scoffings DJ, Pickard JD, Higgins JN. Resolution of transverse sinus stenoses immediately after CSF withdrawal in idiopathic intracranial hypertension. <em>J Neurol Neurosurg Psychiatry<\/em>. 2007;78(8):911\u2013912. doi:10.1136\/jnnp.2006.111765<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_19_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_12_6928\" class=\"footnote\">Bono F, Giliberto C, Mastrandrea C, Cristiano D, Lavano A, Fera F, Quattrone A. Transverse sinus stenoses persist after normalization of the CSF pressure in IIH. <em>Neurology<\/em>. 2005;65(7):1090\u20131093. doi:10.1212\/01.wnl.0000178889.63571.e5<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_20_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_13_6928\" class=\"footnote\">De Simone R, Ranieri A, Montella S, Bilo L, Cautiero F. The role of dural sinus stenosis in idiopathic intracranial hypertension pathogenesis: the self-limiting venous collapse feedback-loop model. <em>Panminerva Med<\/em>. 2014;56(3):201\u2013209.<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_21_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_14_6928\" class=\"footnote\">Lim J, Monteiro A, Kuo CC, Jacoby WT, Cappuzzo JM, Becker AB, Davies JM, Snyder KV, Levy EI, Siddiqui AH. Stenting for Venous Sinus Stenosis in Patients With Idiopathic Intracranial Hypertension: An Updated Systematic Review and Meta-Analysis of the Literature. <em>Neurosurgery<\/em>. 2024;94(4):648\u2013656. doi:10.1227\/neu.0000000000002718<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_22_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_15_6928\" class=\"footnote\">Ahmed RM, Wilkinson M, Parker GD, Thurtell MJ, Macdonald J, McCluskey PJ, Allan R, Dunne V, Hanlon M, Owler BK, Halmagyi GM. Transverse Sinus Stenting for Idiopathic Intracranial Hypertension: A Review of 52 Patients and of Model Predictions. <em>AJNR Am J Neuroradiol<\/em>. 2011;32(8):1408\u20131414. doi:10.3174\/ajnr.A2575<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_23_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_16_6928\" class=\"footnote\">Mejia-Vergara AJ, Sultan W, Kostas A, Mulholland CB, Sadun A. Styloidogenic Jugular Venous Compression Syndrome with Papilloedema: Case Report and Review of the Literature. <em>Neuroophthalmology<\/em>. 2021;46(1):54\u201358. doi:10.1080\/01658107.2021.1887288<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_25_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_51_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_57_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_17_6928\" class=\"footnote\">Dashti SR, Nakaji P, Hu YC, et al. Styloidogenic jugular venous compression syndrome: diagnosis and treatment: case report. <em>Neurosurgery<\/em>. 2012;70(3):E795 \u2013 E799. doi:10.1227\/NEU.0b013e3182333859<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_26_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_52_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_18_6928\" class=\"footnote\">Pokeerbux MR, Delmaire C, Morell-Dubois S, Demondion X, Lambert M. Styloidogenic compression of the internal jugular vein, a new venous entrapment syndrome? <em>Vasc Med<\/em>. 2020;25(4):378\u2013380. doi:10.1177\/1358863X20902842<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_27_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_29_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_19_6928\" class=\"footnote\">Scerrati A, Norri N, Mongardi L, et al. Styloidogenic-cervical spondylotic internal jugular venous compression, a vascular disease related to several clinical neurological manifestations: diagnosis and treatment \u2013 a comprehensive literature review. <em>Ann Transl Med<\/em>. 2021;9(8):718. doi:10.21037\/atm-20-7698<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_28_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_30_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_20_6928\" class=\"footnote\">Zhou D, Meng R, Zhang X, et al. Intracranial hypertension induced by internal jugular vein stenosis can be resolved by stenting. <em>Eur J Neurol<\/em>. 2018;25(2):365-e13. doi:10.1111\/ene.13512<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_32_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_55_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_58_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_62_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_21_6928\" class=\"footnote\">Holmlund P, Johansson E, Qvarlander S, W\u00e5hlin A, Ambarki K, Koskinen LO, Malm J, Eklund A. Human jugular vein collapse in the upright posture: implications for postural intracranial pressure regulation. <em>Fluids Barriers CNS<\/em>. 2017;14:17. doi:10.1186\/s12987-017-0065-2<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_33_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_35_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_22_6928\" class=\"footnote\">San Mill\u00e1n Ru\u00edz D, Gailloud P, R\u00fcfenacht DA, Delavelle J, Henry F, Fasel JH. The craniocervical venous system in relation to cerebral venous drainage. <em>AJNR Am J Neuroradiol<\/em>. 2002;23(9):1500\u20131508.<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_34_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_23_6928\" class=\"footnote\">Gisolf J, van Lieshout JJ, van Heusden K, Pott F, Stok WJ, Karemaker JM. Human cerebral venous outflow pathway depends on posture and central venous pressure. <em>J Physiol<\/em>. 2004;560(Pt 1):317\u2013327. doi:10.1113\/jphysiol.2004.070409<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_36_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_24_6928\" class=\"footnote\">Marini TJ, Chughtai K, Nuffer Z, Hobbs SK, Kaproth-Joslin K. Blood finds a way: pictorial review of thoracic collateral vessels. <em>Insights Imaging<\/em>. 2019;10(1):63. doi:10.1186\/s13244-019-0753-3<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_37_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_38_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_25_6928\" class=\"footnote\">Chahwala V, Tashiro J, Li X, Baqai A, Rey J, Robinson HR. Venous Thoracic Outlet Syndrome as a Cause of Intractable Migraines. <em>Ann Vasc Surg<\/em>. 2017;39:285.e5\u2013285.e8. doi:10.1016\/j.avsg.2016.05.109<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_39_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_46_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_65_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_26_6928\" class=\"footnote\">Ahn SS, Miller TJ, Chen SW, Chen JF. Internal jugular vein stenosis is common in patients presenting with neurogenic thoracic outlet syndrome. <em>Ann Vasc Surg<\/em>. 2014;28(4):946\u2013950. doi:10.1016\/j.avsg.2013.12.009<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_40_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_45_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_56_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_63_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_64_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_27_6928\" class=\"footnote\">Raskin NH, Howard MW, Ehrenfeld WK. Headache as the leading symptom of the thoracic outlet syndrome. <em>Headache<\/em>. 1985;25(4):208\u2013210. doi:10.1111\/j.1526-4610.1985.hed2504208.x<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_41_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_44_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_59_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_66_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_28_6928\" class=\"footnote\">Cha YH, Randall L, Weber J, Ahn S. Treatment of thoracic outlet syndrome to relieve chronic migraine. <em>Clin Anat<\/em>. 2025;38(3):314\u2013323. doi:10.1002\/ca.24242<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_42_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_43_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_47_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_60_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_67_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_29_6928\" class=\"footnote\">Midtlien JP, Curry BP, Chang E, et al. Characterizing a new clinical phenotype: the co-existence of cerebral venous outflow and connective tissue disorders. <em>Front Neurol<\/em>. 2023;14:1305972. doi:10.3389\/fneur.2023.1305972<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_48_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_30_6928\" class=\"footnote\">Manupipatpong S, Primiani CT, Fargen KM, et al. Jugular venous narrowing and spontaneous spinal cerebrospinal fluid leaks: A case \u2013 control study exploring association and proposed mechanism. <em>Interv Neuroradiol<\/em>. 2024;30(6):812\u2013818. doi:10.1177\/15910199241287417<span class=\"footnote-back-link-wrapper\">[<a href=\"#identifier_49_6928\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><\/ol>","protected":false},"excerpt":{"rendered":"<p>Geni\u015fleyen kan\u0131t birikimi g\u00f6steriyor: \u00abidiyopatik\u00bb intrakraniyal hipertansiyon s\u0131kl\u0131kla mekanik bir sorundur \u2013 beynin ven\u00f6z drenaj\u0131n\u0131n C1 d\u00fczeyindeki juguler ven kompresyonu veya torasik \u00e7\u0131k\u0131\u015ftan kaynakl\u0131 t\u0131kanmas\u0131. K\u0131rk y\u0131ll\u0131k klinik veri ve cerrahi sonu\u00e7lar.<\/p>\n","protected":false},"author":2,"featured_media":6944,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"content-type":"","footnotes":""},"categories":[25],"tags":[],"class_list":["post-6928","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-beyin-hastaliklari"],"acf":[],"_links":{"self":[{"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/posts\/6928","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/comments?post=6928"}],"version-history":[{"count":3,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/posts\/6928\/revisions"}],"predecessor-version":[{"id":6974,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/posts\/6928\/revisions\/6974"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/media\/6944"}],"wp:attachment":[{"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/media?parent=6928"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/categories?post=6928"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kamranaghayev.com\/tr\/wp-json\/wp\/v2\/tags?post=6928"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}