Multiple Variations of the Superficial Jugular Veins: Case Report and Clinical Relevance

Abstract

The jugular venous system constitutes the primary venous drainage of the head and neck. It includes a profundus or subfascial venous system, formed by the two internal jugular veins, and a superficial or subcutaneous one, formed by the two anterior and two external jugular veins. We report one case of unilateral anatomical variations of the external and anterior jugular veins. Particularly, on the right side, three external jugular veins co-existed with two anterior jugular veins. Such a combination of venous anomalies is extremely rare. The awareness of the variability of these veins is essential to anesthesiologists and radiologists, since the external jugular vein constitutes a common route for catheterization. Their knowledge is also important to surgeons performing head and neck surgery.

Communicating vein between the right external and internal jugular veins: a case report

“…In the current literature, variations of the jugular veins have been well reported. Paraskevas et al [4] reported a rare case where three external jugular veins were found to co-exist with two anterior jugular veins. In contrast, another case report reported absence of the left EJV.…”

Review of the Variations of the Superficial Veins of the Neck

“…The junction of the posterior division of the retromandibular vein and the posterior auricular vein usually form the EJV that then continues to drain into the subclavian vein [ 3 - 6 ]. The EJV is sometimes absent ipsilaterally or bilaterally, which means that the veins forming the EJV usually drain into the IJV [ 7 - 8 ]. The EJV usually receives distribution from the transverse cervical vein, the anterior jugular vein, the suprascapular vein, and the superficial cervical vein (Figure 1 ).…”

“…Additionally, a double EJV emerging from the parotid gland as two independent veins has been described [ 11 ]. The presence of three right-sided EJVs running in a parallel fashion and draining into the right subclavian vein in a male cadaveric specimen was reported [ 8 ]. Moreover, in this cadaver, there were two anterior jugular veins that drained into the right brachiocephalic vein.…”

“…There can be many variations with respect to the venous drainage of the neck. One such variation is a vein originating in the occipital region, usually a tributary of the common facial vein, which travels obliquely along the anterior border of the sternocleidomastoid muscle (SCM) and eventually drains into the IJV, middle part of the EJV, jugular venous arch, or brachiocephalic vein [ 2 , 8 ]. The posterosuperior superficial muscles and skin are drained by this vein.…”

“…The anterior jugular veins can have variations such as one vein running in the midline of the neck, which is termed the median cervical vein [ 1 , 8 ]. Another variation manifests as two parallel anterior jugular vessels, one opening into the external jugular vein and one into the transverse cervical vein.…”