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Introduction Cerebral venous sinus thrombosis (CVST) is a rare but serious condition that may result in intracranial hypertension, venous infarction, or hemorrhage. While common causes include thrombophilia or hormonal factors, mechanical obstruction from anatomical anomalies such as jugular Eagle syndrome should also be considered. This syndrome involves compression of the internal jugular vein by an elongated styloid process, leading to impaired cerebral venous drainage.Abstract C25 Figure 1Case Description We report the case of a 44-year-old woman presenting with severe right-sided headache, neck pain, and visual disturbances after cervical spine manipulation. CT venography revealed extensive sinus thrombosis with venous congestion hemorrhage and right-sided internal jugular vein compression by a 3.5 cm styloid process. Anticoagulation alone was insufficient to relieve symptoms, prompting urgent endovascular thrombectomy via a transvenous approach. Near-complete recanalization was achieved using a stent retriever and aspiration technique. The patient improved clinically and was discharged in stable condition. Due to ongoing jugular vein compression, surgical styloidectomy was considered for long-term management.Abstract C25 Figure 2Conclusions This case highlights the importance of considering jugular Eagle syndrome in patients with unexplained CVST or atypical venous outflow patterns. While anticoagulation remains first-line therapy, mechanical thrombectomy may be required in refractory cases, and anatomical correction via surgery may prevent recurrence. Early diagnosis through advanced imaging and multidisciplinary collaboration is key to optimizing outcomes in such complex cases.Abstract C25 Figure 3Conflict of Interest No