Spinal accessory neuropathy is a rare complication of carotid endarterectomy (CEA).1 Internal jugular venous thrombosis after CEA has also been reported rarely, but is likely more common; as internal jugular venous thrombosis is often asymptomatic, or presents with non-specific pain, it is probably unrecognised in many cases.2 Concurrent ipsilateral spinal accessory neuropathy and internal jugular venous thrombosis after CEA is expected to be rare, and this is underscored by the lack of published cases. Despite this apparent rarity, a common pathogenetic mechanism for postoperative spinal accessory neuropathy and internal jugular venous thrombosis may well be present, at least in some cases, which may lead to the consideration of the possibility of both when either is discovered.

We report on a patient who developed right spinal accessory neuropathy and internal jugular venous thrombosis after right CEA.

A 59 year old man underwent right CEA for possibly symptomatic stenosis. Angiography had shown 90% stenosis of the right internal carotid. The operation was done under general anaesthesia. The carotid bifurcation was unusually distal, necessitating a long …