Internal jugular vein thrombosis associated with venous hypoplasia and protein S deficiency revealed by ultrasonography

Lim, Byung Gun; Kim, Young Min; Kim, Heezoo; Lim, Sang Ho; Lee, Mi Kyoung

doi:10.1007/s00540-011-1233-1

Cited by 6 publications

(5 citation statements)

References 12 publications

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“…Venous narrowing can be caused either directly due to intraluminal defects or hypoplasia, or as a result of blockages such as venous thrombosis. 13,16 As BMI is linked with increased risk of CNS diseases, we expected to find more pronounced narrowing in a cohort of MS patients when compared with HIs. We were also interested to explore the cervical level at which CSA reduction would impact these associations.…”

Section: Introductionmentioning

confidence: 95%

Internal jugular vein narrowing and body mass index in healthy individuals and multiple sclerosis patients

Magnano

Belov²,

Krawiecki³

et al. 2014

Veins and Lymphatics

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Internal jugular vein (IJV) narrowing has been implicated in central nervous system (CNS) disorders. Body mass index (BMI) is a cardiovascular risk factor that has been also linked to CNS diseases, however it is unknown whether a relationship exists between IJV narrowing and BMI. The objectives were to assess the relationship between IJV cross-sectional areas (CSA) and BMI in healthy individuals (HI) and multiple sclerosis (MS) patients. A total of 388 subjects (194 age-and sexmatched HI and MS patients) received magnetic resonance venography and structural brain magnetic resonance imaging at 3T. Region of interest analysis was performed using a semiautomated contouring-thresholding technique to determine the minimum CSA of the IJVs at C2/C3, C5/C6, and C7/T1 cervical levels. Partial correlation analyses were used to determine the associations. Increased BMI was related to increased IJV CSA at lower cervical levels (r=0.240, P<0.0001 at C5/C6 and r=0.293, P<0.0001 at C7/T1) in both MS patients and HI. Both MS and HI, showed associations between increased BMI and IJV CSA measures, particularly at lower cervical locations, in individual group analyses. No differences in association between BMI and IJV CSA were observed between HI and MS patients. Relationship between IJV CSA and BMI were not significant at upper cervical locations in the studied groups. Increased BMI is associated with IJV CSA widening, rather than narrowing, at lower cervical levels in both MS patients and HI. This finding warrants further investigation, but indicates that BMI can obscure interpretation of IJV CSA narrowing.

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Section: Introductionmentioning

confidence: 95%

Internal jugular vein narrowing and body mass index in healthy individuals and multiple sclerosis patients

Magnano

Belov²,

Krawiecki³

et al. 2014

Veins and Lymphatics

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“…IJVthr is often a complication of head and neck, local skin, and throat infections [ 23 , 24 , 46 , 47 , 48 ], surgery [ 49 , 50 , 51 ], trauma [ 17 ], local or distant malignancy [ 3 , 11 , 25 , 51 , 52 ], central venous catheter placement [ 43 , 44 , 45 ], polycythemia vera [ 37 , 53 , 54 , 55 ], intravenous drug abuse [ 56 , 57 ], neck massage [ 12 ], ovarian hyperstimulation syndrome [ 58 , 59 , 60 , 61 ], hypercoagulable state secondary to factor V Leiden, protein C, protein S, anti-phospholipid syndrome, anti-thrombin III deficiency [ 13 , 14 , 36 , 62 , 63 , 64 , 65 ], or it can be a primary process [ 1 , 3 , 4 , 5 ].…”

Section: Resultsmentioning

confidence: 99%

Internal Jugular Vein Thrombosis: Etiology, Symptomatology, Diagnosis and Current Treatment

et al. 2021

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(1) Background: internal jugular vein thrombosis (IJVthr) is a potentially life-threating disease but no comprehensive reviews on etiology, symptomatology, diagnosis and current treatment guidelines are yet available; (2) Methods: we prospectively developed a protocol that defined objectives, search strategy for study identification, criteria for study selection, data extraction, study outcomes, and statistical methodology, according to the PRISMA standard. We performed a computerized search of English-language publications listed in the various electronic databases. We also retrieved relevant reports from other sources, especially by the means of hand search in the Glauco Bassi Library of the University of Ferrara; (3) Results: using the predefined search strategy, we retrieved and screened 1490 titles. Data from randomized control trials were few and limited to the central vein catheterization and to the IJVthr anticoagulation treatment. Systematic reviews were found just for Lemierre syndrome, the risk of pulmonary embolism, and the IJVthr following catheterization. The majority of the information required in our pre-defined objectives comes from perspectives observational studies and case reports. The methodological quality of the included studies was from moderate to good. After title and abstract evaluation, 1251 papers were excluded, leaving 239 manuscripts available. Finally, just 123 studies were eligible for inclusion. We found out the description of 30 different signs, symptoms, and blood biomarkers related to this condition, as well as 24 different reported causes of IJVthr. (4) Conclusions: IJVthr is often an underestimated clinical problem despite being one of the major sources of pulmonary embolism as well as a potential cause of stroke in the case of the upward propagation of the thrombus. More common symptoms are neck pain and headache, whereas swelling, erythema and the palpable cord sign beneath the sternocleidomastoid muscle, frequently associated with fever, are the most reported clinical signs. An ultrasound of the neck, even limited to the simple and rapid assessment of the compression maneuver, is a quick, economic, cost-effective, noninvasive tool. High quality studies are currently lacking.

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“…Isolated internal jugular vein aneurysms are the most frequently encountered anomalies of the venous system of the neck, and internal jugular vein agenesis and hypoplasia, associated with compensatory aneurysmal dilation of the contralateral venous axis have been also reported ( 1 ). Incidental thrombosis of a hypoplasic ( 5 ) or of an aneurismal jugular vein ( 6 ) have been previously described in patients with risk factors for thrombosis, generally without embolic complications. Usually, thromboembolic events are caused by aneurysms in the lower limb veins (popliteal, femoral), and a single case of a cephalic vein with secondary pulmonary embolism was previously reported ( 7 ).…”

Section: Discussionmentioning

confidence: 99%

An atypical case of pulmonary embolism from a jugular vein

et al. 2018

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SummaryNeck venous malformations and their potentially life-threatening complications are rarely reported in the available literature. Cases of aneurysmal or hypo-plastic jugular vein thrombosis associated with systemic embolization have not been frequently reported. We present the case of a 60-year-old male, without any known risk factors for thromboembolic disease, admitted for sudden onset dyspnea. The physical examination was remarkable for a right lateral cervical mass, expanding with Valsalva maneuver. Thoracic CT with contrast established the diagnosis of bilateral pulmonary embolism and raised the suspicion of superior vena cava and right atrial thrombosis. Bedside transthoracic echocardiography confirmed the presence of a large right atrial thrombus, with intermittent protrusion through the tricuspid valve. Systemic thrombolysis with Alteplase was initiated shortly after diagnosis, in parallel with unfractionated heparin, with complete resolution of the intracavitary thrombus documented by echocardiography. The patient showed significant improvement in symptoms and was later started on oral anticoagulation. Computed vascular tomography of the neck was performed before discharge, showing hypoplasia of the left internal jugular vein and aneurismal dilation of the contralateral internal jugular vein, without thrombosis. There were no identifiable systemic causes for thrombosis. Surgical resection of the aneurismal jugular vein was excluded, because of its potential to cause intracranial hypertension. The preferred therapeutic option in this case was long-term oral anticoagulation.Learning points:Internal jugular venous malformations, such as aneurisms or hypoplasia, could be associated with an increased risk of thrombosis and major embolic events.Systemic thrombolysis can be an efficient solution in cases of pulmonary embolism with right heart thrombosis.Multimodality imaging is greatly valuable in clarifying the diagnosis of atypical cases.

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Internal jugular vein thrombosis associated with venous hypoplasia and protein S deficiency revealed by ultrasonography

Cited by 6 publications

References 12 publications

Internal jugular vein narrowing and body mass index in healthy individuals and multiple sclerosis patients

Internal jugular vein narrowing and body mass index in healthy individuals and multiple sclerosis patients

Internal Jugular Vein Thrombosis: Etiology, Symptomatology, Diagnosis and Current Treatment

An atypical case of pulmonary embolism from a jugular vein

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