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Background <p>Cervical compartment syndrome is an exceptionally rare but potentially life-threatening condition characterized by increased intercompartmental pressure within the neck, leading to neurovascular compromise, airway obstruction, and tissue necrosis. Due to its rarity and nonspecific presentation, diagnosis and timely intervention remain challenging. This study aims to present three cases of cervical compartment syndrome and contextualize their clinical presentation, etiology, management, and outcomes through a narrative review of the literature.</p> Methods <p>We present a retrospective case series of three patients who developed cervical compartment syndrome from varied etiologies: prolonged immobilization, subclavian central line infiltration during trauma resuscitation, and prolonged intraoperative neck positioning. A comprehensive literature review was also conducted to contextualize clinical presentation, diagnostic approaches, and management strategies.</p> Results <p>All patients exhibited rapid neck swelling with neurological deficits or hemodynamic instability. One case was managed conservatively; the others required emergency surgical decompression. Etiologies included pressure-induced rhabdomyolysis, iatrogenic fluid extravasation, and venous outflow obstruction. Airway compromise and elevated compartment pressures were common themes. Two patients demonstrated complete neurological recovery during follow-up, while one patient died due to complications of massive hemorrhage unrelated to cervical decompression.</p> Conclusion <p>Compartment syndrome of the neck, also known as cervical compartment syndrome, though rare, should be considered in rapidly expanding neck swellings with signs of airway or vascular compromise. It is a critical condition that requires a high index of suspicion, especially in trauma, postoperative, or iatrogenic settings. Early recognition, timely airway protection, and prompt surgical decompression when indicated may be lifesaving and are often required to reduce the risk of irreversible neurovascular injury and adverse outcomes.</p>

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Cervical compartment syndrome: a case series and narrative review of clinical presentation, surgical management, and outcomes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月20日

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  • Ahmed Mohsen Abbas El-Hagrasy,
  • Abdullatif A S M Alhashel,
  • Moumen Ahmed,
  • Maryam Aljawi

摘要

Background

Cervical compartment syndrome is an exceptionally rare but potentially life-threatening condition characterized by increased intercompartmental pressure within the neck, leading to neurovascular compromise, airway obstruction, and tissue necrosis. Due to its rarity and nonspecific presentation, diagnosis and timely intervention remain challenging. This study aims to present three cases of cervical compartment syndrome and contextualize their clinical presentation, etiology, management, and outcomes through a narrative review of the literature.

Methods

We present a retrospective case series of three patients who developed cervical compartment syndrome from varied etiologies: prolonged immobilization, subclavian central line infiltration during trauma resuscitation, and prolonged intraoperative neck positioning. A comprehensive literature review was also conducted to contextualize clinical presentation, diagnostic approaches, and management strategies.

Results

All patients exhibited rapid neck swelling with neurological deficits or hemodynamic instability. One case was managed conservatively; the others required emergency surgical decompression. Etiologies included pressure-induced rhabdomyolysis, iatrogenic fluid extravasation, and venous outflow obstruction. Airway compromise and elevated compartment pressures were common themes. Two patients demonstrated complete neurological recovery during follow-up, while one patient died due to complications of massive hemorrhage unrelated to cervical decompression.

Conclusion

Compartment syndrome of the neck, also known as cervical compartment syndrome, though rare, should be considered in rapidly expanding neck swellings with signs of airway or vascular compromise. It is a critical condition that requires a high index of suspicion, especially in trauma, postoperative, or iatrogenic settings. Early recognition, timely airway protection, and prompt surgical decompression when indicated may be lifesaving and are often required to reduce the risk of irreversible neurovascular injury and adverse outcomes.