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The obstruction of cerebral venous drainage is an entity rarely recognized in clinical practice but may be implicated in the pathogenesis of situations such as Pseudotumor cerebrii, migraine, or even multiple sclerosis. When symptomatic, it presents with signs and symptoms of chronic intracranial hypertension, namely, headache, papilledema, and more rarely pulsatile tinnitus, as a result of cerebral venous stasis. The most common causes are cerebral venous thrombosis, extrinsic compression by tumor, fracture submerged with achievement of the venous system and rarely the jugular vein compression by a hypertrophic styloid process of the temporal bone. Numerous anatomical variations of this process have been reported, causing several clinical findings according to the anatomical structure affected. The authors report a unique case of unilateral compression of the internal jugular vein in the upper cervical region (between a redundant styloid process and the lateral mass of C1), which presented by sudden headache and meningism, mimicking a subarachnoid hemorrhage (SAH). We reviewed the possible implications of this anatomical variation on cerebral venous circulation, the possible pathological consequences and therapeutic options. The occurrence of impaired venous drainage by extrinsic compression of the internal jugular vein at the base of the skull, according to the authors, should be screened whenever there are complaints of idiopathic intracranial hypertension or evidence of unexplained intracranial bleeding.

Variação Anatômica da Apófise Estilóidea do Osso Temporal como Causa de Hipertensão Venosa Cerebral Súbita