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Journal of Neurology, Neurosurgery, and... Apr 2005Recently a causal relation between internal jugular vein valve incompetence (IJVVI) and transient global amnesia (TGA) has been suggested. IJVVI is postulated to provoke...
BACKGROUND
Recently a causal relation between internal jugular vein valve incompetence (IJVVI) and transient global amnesia (TGA) has been suggested. IJVVI is postulated to provoke a transient mesiotemporal ischaemia by venous congestion. This mechanism requires a patent venous pathway from the affected IJV through the transverse sinus, confluens, straight sinus (SS), vein of Galen into the basal vein of Rosenthal and the internal cerebral veins.
OBJECTIVE
To study IJVVI in TGA patients in relation to the intracranial venous anatomy.
METHODS
IJVVI was defined if a repeated Valsalva manoeuvre (VM) led to a retrograde jugular flow detected by extracranial duplex ultrasound. Non-contrast venous MR angiography (MRA) was performed to analyse intracranial drainage patterns of the SS in relation to the side of the IJVVI. SS drainage was differentiated into three groups: predominantly right, left, and bilateral drainage. Ultrasound studies were performed in 25 TGA patients and 85 age matched controls. Twenty patients underwent venous MRA.
RESULTS
Sixty eight per cent of patients and 33% of controls showed unilateral or bilateral IJVVI (p = 0.0025). In 36% of patients a TGA preceding VM was reported. Drainage pattern of SS and side of IJVVI corresponded in five of eight patients (63%) with VM and four of 12 patients without VM (33%, p = 0.0994).
CONCLUSION
Our study confirms the significantly higher prevalence of IJVVI in TGA patients. However, no specific IJVVI related intracranial venous drainage patterns could be found to further support the hypothesis of a direct causal relation between IJVVI and TGA.
Topics: Adult; Aged; Aged, 80 and over; Amnesia, Transient Global; Brain; Brain Ischemia; Cerebrovascular Circulation; Female; Humans; Jugular Veins; Magnetic Resonance Angiography; Male; Middle Aged; Prospective Studies; Radiography; Severity of Illness Index; Ultrasonography, Doppler, Duplex; Valsalva Maneuver; Venous Insufficiency
PubMed: 15774436
DOI: 10.1136/jnnp.2004.043844 -
Journal of Ultrasound Jun 2024Vascular access in neonates and small infants is often challenging. Ultrasound (US) screening and guidance improves its safety and efficacy. The advantages of a... (Review)
Review
Vascular access in neonates and small infants is often challenging. Ultrasound (US) screening and guidance improves its safety and efficacy. The advantages of a pre-implantation ultrasound examination are intuitive; it is a practical and safe technique that doesn't use radiation, allowing static and dynamic evaluations to be carried out and identifying anatomical variations, the caliber and depth of the vessel, the patency of the entire course and attached structures (nerves, etc.). Optimization of the image is a crucial aspect in achieving a clear view of all anatomical structures while avoiding complications. The goal of this review was to look into the benefits of using US in invasive catheter insertion procedures, especially in pediatric patients. Ultrasonography is used to visualize vessels and related structures in two dimensions (2D), sometimes with the help of color Doppler to detect the presence of intraluminal thrombi by applying gentle compression to assess vessel collapse and evaluate morphologic changes in the internal jugular vein (IJV) who had undergone central venous catheter (CVC) insertion during the neonatal period (Montes-Tapia et al. in J Pediatr Surg 51:1700-1703, 2016).
Topics: Humans; Infant, Newborn; Catheterization, Central Venous; Ultrasonography, Interventional; Ultrasonography; Jugular Veins
PubMed: 37801208
DOI: 10.1007/s40477-023-00832-1 -
PloS One 2014Although ultrasonography is recommended in internal jugular vein (IJV) catheterization, the landmark-guided technique should still be considered. The central landmark... (Clinical Trial)
Clinical Trial
BACKGROUND
Although ultrasonography is recommended in internal jugular vein (IJV) catheterization, the landmark-guided technique should still be considered. The central landmark using the two heads of the sternocleidomastoid muscle is widely used, but it is inaccurate for IJV access. As an alternative landmark, we investigated the accuracy of the new landmark determined by inspection of the respiratory jugular venodilation and direct IJV palpation in right IJV access by ultrasonography.
METHODS AND FINDINGS
Thirty patients were enrolled. After induction of anesthesia, the central landmark was marked at the cricoid cartilage level (M1) and the alternative landmark determined by inspection of the respiratory jugular venodilation and direct palpation of IJV was also marked at the same level (M2). Using ultrasonography, the location of IJV was identified (M3) and the distance between M1 and M3 as well as between M2 and M3 were measured. The median (interquartile range) distance between the M2 and M3 was 3.5 (2.0-6.0) mm, compared to 17.5 (12.8-21.3) mm between M1 and M3. (P<0.001) The dispersion of distances between M2 and M3 was significantly smaller than between M1 and M3. (P<0.001) The visibility of respiratory jugular venodilation was associated with CVP more than 4 mmHg. Limitations of the present study are that the inter-observer variability was not investigated and that the visibility of the alternative landmark can be limited to right IJV in adults.
CONCLUSION
The alternative landmark may allow shorter distance for the right side IJV access than the central landmark and can offer advantages in right IJV catheterization when ultrasound device is unavailable.
TRIAL REGISTRATION
Clinical Research Informational Service KCT0000812.
Topics: Aged; Anesthesiology; Catheterization, Central Venous; Female; Humans; Jugular Veins; Male; Middle Aged; Palpation; Prospective Studies; Ultrasonography
PubMed: 25050554
DOI: 10.1371/journal.pone.0103089 -
Colombia Medica (Cali, Colombia) 2015The internal jugular vein locates anterior or anterolateral to the common carotid artery in two-thirds of the subjects studied by ultrasound when the head is in a...
INTRODUCTION
The internal jugular vein locates anterior or anterolateral to the common carotid artery in two-thirds of the subjects studied by ultrasound when the head is in a rotated position.
AIM
To identify variables associated with the anterior location of the internal jugular vein.
METHODS
Ultrasound examinations were performed with the patients in the supine position, with the head rotated to the opposite side. The proximal third of the neck was visualized transversely with a 7.5-mHz transducer. The relationship between the vessels was described in accordance with the proportion of the artery overlapped by the vein. Univariate comparisons and a multivariate analysis of potential variables that may affect the anatomic relationships were performed.
RESULTS
Seventy-eight patients were included, 44 of whom were men. The patients' ages ranged from 17 to 90 years (median 64.0, interquartile range 41-73). The right and left sides were studied 75 and 73 times, respectively. The vein was located lateral to the artery in 24.3% (95%CI= 17.4-32.2) of the studies, anterolateral in 33.8% (95%CI= 26.2-41.4) and anterior in 41.9% (95%CI= 33.9-49.8). The multivariate analysis identified age group (OR= 3.7, 95% CI 2.1-6.4) and, less significantly, the left side (OR= 1.7, 95%CI= 0.8-3.5) and male gender (OR= 1.2, 95%CI= 0.6-2.7) as variables associated with the anterior position of the vein.
CONCLUSIÓN
The anterior position of the internal jugular vein relative to the common carotid artery increases gradually with age. Additionally, left-sided localization and male sex further increased the probability of an anterior position.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Carotid Artery, Common; Cross-Sectional Studies; Female; Humans; Jugular Veins; Male; Middle Aged; Multivariate Analysis; Sex Factors; Supine Position; Ultrasonography; Young Adult
PubMed: 26309339
DOI: No ID Found -
AJNR. American Journal of Neuroradiology Jan 2012Transvenous interventions for intracranial vascular lesions are usually performed via venous access of a femoral vein puncture. However, the transjugular route is an...
Transvenous interventions for intracranial vascular lesions are usually performed via venous access of a femoral vein puncture. However, the transjugular route is an alternative with a shorter and less tortuous vascular access for intracranial lesions. Although puncture of the internal jugular vein is generally believed to be too dangerous owing to potential hazardous complications, the safety of the sonographically guided retrograde internal jugular vein puncture technique for intracranial intervention has not been fully evaluated in the English literature. We present our experience with a total of 44 transjugular intervention procedures between April 1999 and June 2010. We believe sonographically guided internal jugular vein puncture is a safe and efficacious technique for establishing transvenous access for an intracranial endovascular intervention.
Topics: Angioplasty; Catheterization, Central Venous; Cerebral Revascularization; Humans; Jugular Veins; Male; Middle Aged; Punctures; Radiography; Surgery, Computer-Assisted; Treatment Outcome; Ultrasonography, Interventional
PubMed: 22158929
DOI: 10.3174/ajnr.A2416 -
Journal of Magnetic Resonance Imaging :... Nov 2022Cerebral venous pathways are subjected to geometrical and patency changes due to body position. The internal jugular veins (IJVs) are the main venous drainage pathway in...
BACKGROUND
Cerebral venous pathways are subjected to geometrical and patency changes due to body position. The internal jugular veins (IJVs) are the main venous drainage pathway in supine position. Their patency and geometry should be evaluated under different body inclination angles over a three-dimensional (3D) volume in the healthy situation to better understand pathological cases.
PURPOSE
To investigate whether positional changes in the body can affect the geometrical properties and patency of the venous system.
STUDY TYPE
Prospective.
POPULATION
15 healthy volunteers, of which seven males and median age 22 years in a range of 19-59.
FIELD STRENGTH/SEQUENCE
A 0.25-T tiltable MRI system was used to scan volunteers in 90° (sitting position), 69°, 45°, 21°, and 0° (supine position) in the transverse plane with the top at vertebra C2. A gradient echo sequence was used.
ASSESSMENT
Three observers assessed IJVs on patency and created automatic centerlines from which diameter and patency were analysed perpendicular to the vessel at every 4 mm starting at the level of C2.
STATISTICAL TESTS
A Student's t test was used to find statistical difference (p < 0.05) in average IJV diameters per inclination angle.
RESULTS
The amount of fully collapsed IJVs increased from 33% to 93% (left IJV) and 14% to 80% (right IJV) when increasing the inclination angle from 0° to 90°. In both IJVs, the mean diameter (±SD) of the open vessels was significantly higher at 0° than 90° with 6.3 ± 0.5 mm vs. 4.4 ± 0.1 mm (left IJV) and 6.6 ± 0.6 mm vs. 4.3 ± 0.4 mm (right IJV).
DATA CONCLUSION
Tiltable low-field MRI can be used to assess IJV geometry and its associated venous pathways in 3D under multiple inclination angles. Next to a higher amount of collapsed vessels, the average diameter of noncollapsed vessels decreases with increasing inclination angles for both left and right IJVs.
LEVEL OF EVIDENCE
2 TECHNICAL EFFICACY STAGE: 1.
Topics: Adult; Healthy Volunteers; Humans; Jugular Veins; Magnetic Resonance Imaging; Male; Middle Aged; Prospective Studies; Young Adult
PubMed: 35322920
DOI: 10.1002/jmri.28182 -
Singapore Medical Journal Aug 2015We studied the effect of head rotation on the relative position of the right common carotid artery (CCA) and the right internal jugular vein (IJV) in patients with... (Observational Study)
Observational Study
INTRODUCTION
We studied the effect of head rotation on the relative position of the right common carotid artery (CCA) and the right internal jugular vein (IJV) in patients with laryngeal mask airway (LMA) insertion to evaluate the accuracy of anatomical landmarks for right IJV cannulation.
METHODS
We simulated needle insertion to the right IJV on sonograms via the central landmark approach and an approach using the external jugular vein, in patients with LMA insertion (n = 50) or endotracheal intubation (E-tube, n = 50). Overlap index and successful simulation rates were measured according to the different degrees of head rotation.
RESULTS
The overlap index between the right CCA and the right IJV increased with greater degrees of head rotation. It was significantly greater in the LMA insertion group than in the E-tube group in the following head rotation positions: neutral, 15° and 45°. The success rate of the simulation was lower in the LMA insertion group than in the E-tube group. In the LMA insertion group, the success rate of the simulation was highest (62%) with the central landmark approach and in the 15° head rotation position.
CONCLUSION
In the LMA insertion group, the overlap index increased incrementally with greater head rotation degrees (from neutral to 45°). The central landmark approach and 15° head rotation position appear to be the optimal puncture site and degree of head rotation for right IJV cannulation in patients with LMA insertion.
Topics: Adult; Anesthesia, General; Carotid Artery, Common; Catheterization, Central Venous; Computer Simulation; Female; Head; Humans; Jugular Veins; Laryngeal Masks; Male; Middle Aged; Needles; Patient Positioning; Prospective Studies; Punctures; Rotation; Ultrasonography
PubMed: 25902718
DOI: 10.11622/smedj.2015068 -
Medicine Feb 2021Intravenous pyogenic granuloma (IVPG) is a special type of pyogenic granuloma, and its preoperative diagnosis is difficult. We report a rare case of IVPG that develops... (Review)
Review
RATIONALE
Intravenous pyogenic granuloma (IVPG) is a special type of pyogenic granuloma, and its preoperative diagnosis is difficult. We report a rare case of IVPG that develops in the lumen of the internal jugular vein (IJV). Here, we analyze the imaging characteristics of present case and summarize the imaging characteristics of previous reported cases.
PATIENT CONCERNS
A 44-year-old man who presented with a growth in the IJV without any symptoms.
DIAGNOSES
A diagnosis of IVPG was made, based on the pathological examination after surgery.
INTERVENTIONS
The patient underwent surgery to excise the vein segment containing the neoplasm.
OUTCOMES
The patient did not present with any complications in the postoperative follow-up period.
LESSONS
For clinician, IVPG's preoperative diagnosis is difficult. Although histopathology remains the gold standard for diagnosis, the combination of multiple types of imaging examinations is necessary to rule out the differential diagnoses of IVPG.
Topics: Adult; Granuloma, Pyogenic; Humans; Jugular Veins; Magnetic Resonance Imaging; Male; Tomography, X-Ray Computed; Ultrasonography; Vascular Diseases
PubMed: 33578554
DOI: 10.1097/MD.0000000000024570 -
Ultrasound in Obstetrics & Gynecology :... Nov 2003The aim of our study was to obtain measurements of the jugular vein and carotid artery pulsatility index (PI) at 10-14 weeks' gestation in chromosomally normal and...
OBJECTIVE
The aim of our study was to obtain measurements of the jugular vein and carotid artery pulsatility index (PI) at 10-14 weeks' gestation in chromosomally normal and abnormal fetuses with or without increased nuchal translucency (NT), in order to explore whether a relationship exists between increased NT and overperfusion of the head.
METHODS
This was a prospective study involving 179 pregnant women at high risk for chromosomal anomalies or structural malformations who were referred for chorionic villus sampling or first-trimester ultrasound examination at 10-14 weeks' gestation, respectively. Color and pulsed Doppler ultrasound were used to obtain jugular vein and carotid artery blood flow velocity waveforms at the level of the mid-neck. All Doppler measurements were obtained by a single investigator. The PIs of the jugular vein and carotid artery were correlated with NT measurement and fetal karyotype.
RESULTS
Doppler measurements of the jugular vein and carotid artery were successfully obtained in 90.5% of the fetuses. The fetal karyotype was abnormal in 13 cases, including three trisomies 21 and two trisomies 18, and normal in 149 cases. In the group with normal karyotype the NT was above the 95th percentile in 22 cases (15%). No correlation between the jugular vein or the carotid artery PI and the thickness of the NT was found. There were no significant differences when comparing the values of the jugular vein and carotid artery PI between the group with normal NT and the group with increased NT, or between the group with a normal karyotype and an abnormal karyotype.
CONCLUSION
Our results suggest that NT is not related to blood flow impedance in either the carotid artery or the jugular vein. Overperfusion and venous congestion of the head do not appear to be a causative pathophysiological mechanism involved in increased NT.
Topics: Adult; Blood Flow Velocity; Carotid Arteries; Female; Gestational Age; Head; Humans; Jugular Veins; Karyotyping; Maternal Age; Neck; Pregnancy; Pregnancy Trimester, First; Prospective Studies; Ultrasonography, Doppler, Color
PubMed: 14618658
DOI: 10.1002/uog.898 -
The Western Journal of Emergency... Mar 2016Despite multiple advantages, subclavian vein (SCV) cannulation via the traditional landmark approach has become less used in comparison to ultrasound (US) guided... (Review)
Review
Despite multiple advantages, subclavian vein (SCV) cannulation via the traditional landmark approach has become less used in comparison to ultrasound (US) guided internal jugular catheterization due to a higher rate of mechanical complications. A growing body of evidence indicates that SCV catheterization with real-time US guidance can be accomplished safely and efficiently. While several cannulation approaches with real-time US guidance have been described, available literature suggests that the infraclavicular, longitudinal "in-plane" technique may be preferred. This approach allows for direct visualization of needle advancement, which reduces risk of complications and improves successful placement. Infraclavicular SCV cannulation requires simultaneous use of US during needle advancement, but for an inexperienced operator, it is more easily learned compared to the traditional landmark approach. In this article, we review the evidence supporting the use of US guidance for SCV catheterization and discuss technical aspects of the procedure itself.
Topics: Catheterization, Central Venous; Humans; Jugular Veins; Subclavian Vein; Ultrasonography, Interventional
PubMed: 26973755
DOI: 10.5811/westjem.2016.1.29462