Venous congestion headaches

The most common complaint we see for head pain is head pressure that won’t go away. Typically we see people that explain to us that when they go to their doctors, they are prescribed a bunch of medications. The medications did not help them. We speculate that if the medications are not getting rid of their headaches, the patient should have a musculoskeletal cause (neck instability) for their headaches explored.

In testing on our patients, we find that the number one structural cause that they suffer from is compression of the jugular veins. The jugular veins are the main drainage port for the brain. Seventy percent of the fluid in the brain is in the venous system (the drainage system that removes wastes from the body and brings deoxygenated blood back to the heart to be re-oxygenated.) While the jugular veins themselves are very large, the other veins of the network can be very small.

If a person has a breakdown of their neck curve caused by cervical neck instability which in turn is causing compression on the jugular veins and the symptoms of headache remain even when they are laying down (when symptoms should be relieved), the person may find themselves in a situation where their headaches become “perplexing,” and a mystery to their doctors. Most of the time headaches do get better when you lay down. If they do not, a significant breakdown of the normal neck structure should be considered as the culprit of jugular vein compression and a lateral x-ray should be taken to assess the structure of the neck.

When you research intracranial hypertension, you will find older articles refer to this problem as pseudotumor cerebri. Pseudotumor means symptoms that mimic a brain tumor. The new terminology is idiopathic intracranial hypertension is called IIH. Idiopathic means the doctors do not know the cause. In many patients we see we discover that the cause of their symptoms and headaches are caused by cervical spine instability causing venous compression.

What are we seeing in the image below?

Below is an image from a 1940 medical paper (1) that was used as a demonstration of where headaches developed in the cerebral venous sinus in a 2016 medical paper by Dr. Mark H. Wilson of Queen Mary College, London. The 2016 paper was published in the Journal of Cerebral Blood Flow and Metabolism. (2)

What Dr. Wilson pointed out was “They (the 1940 researchers) demonstrated that pressure on the sinuses caused significant headache pain.” Further, the pain caused by venous structures has largely been forgotten by doctors.

Basically, the image shows that when you have venous tension in the brain, there are various headaches are produced. This image shows that if you have compression of the jugular veins it’s going to cause venous hypertension in your brain and that can cause many types of headaches. Most people we see don’t complain of a “whole head” pain. Many people have certain parts of their heads where they get their common headaches.

1 Ray BS, Wolff HG. Experimental studies on headache: pain-sensitive structures of the head and their significance in headache. Arch Surg 1940; 4: 813–856. [Google Scholar]
2 Wilson MH. Monro-Kellie 2.0: The dynamic vascular and venous pathophysiological components of intracranial pressure. Journal of Cerebral Blood Flow & Metabolism. 2016 Aug;36(8):1338-50. [Google Scholar]

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