Neck Surgery with Prolonged Internal Jugular Vein Retraction: due to stasis in the internal jugular vein
Internal Jugular Central Venous Catheter/Swan-Ganz Catheter (see Central Venous Catheter): due to local vascular damage or stasis in the internal jugular vein
Subclavian Vein Central Venous Catheter/Swan-Ganz Catheter (see Central Venous Catheter): due stasis in the internal jugular vein
Other
Idiopathic
Internal Jugular IV Drug Abuse: due to local vascular damage to internal jugular vein
Neck Massage
Trauma
Gonadotropin Induction of Ovulation
Diagnosis
Contrast Neck CT: may be the procedure of choice
Low-density thrombus within internal jugular vein
Sharply defined bright internal jugular vessel wall (due to contrast uptake by the vasa vasorum)
Soft tissue swelling surrounding the internal jugular vein
Distended internal jugular vein just proximal to the thrombus
Doppler U/S of Neck Veins: usually diagnostic
Venogram: not usually necessary
Neck MRI: may be useful
Clinical
Pain Over IJ Site: variable
Treatment
Catheter-Related Cases: remove catheter at the first opportunity
Lemierre’s Syndrome-Related Cases: see Lemierre’s Syndrome, [[Lemierres Syndrome]])
Catheter-Directed Thrombolysis: may be indicated for some cases with associated sigmoid sinus thrombosis
Anticoagulation
However, rates of pulmonary embolism from isolated internal jugular vein thrombosis are low
Rate of pulmonary embolism for isolated subclavian/axillary vein thrombosis: 4% [MEDLINE]
Rate of pulmonary embolism for isolated internal jugular vein thrombosis: 0.5% [MEDLINE]
Rate of pulmonary embolism for combined subclavian/axillary vein + internal jugular vein thromboses: 2.4% [MEDLINE]
Superior Vena Cava (SVC) Filter: rarely required for internal jugular vein thrombosis alone (although may be required in some cases with coexisting axillary/subclavian vein thromboses)
References
Acute upper extremity deep venous thrombosis: safety and effectiveness of superior vena caval filters. Radiology. Jan 1999;210(1):53-8 [MEDLINE]
Morbidity and mortality associated with internal jugular vein thromboses. Vasc Endovascular Surg. Jul-Aug 2005;39(4):335-9 [MEDLINE]
Sigmoid sinus thrombosis associated with internal jugular venous occlusion: direct thrombolytic treatment. J Endovasc Surg. Aug 1996;3(3):306-14 [MEDLINE]
