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Jugular Vein Thrombosis
Bronwyn E. Hamilton, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Jugular vein thrombosis (JVT)
              • Definitions

                • JVT: Chronic internal jugular vein (IJV) thrombosis (> 10 days after acute event) in which clot persists within lumen after soft tissue inflammation is gone
                • Jugular vein thrombophlebitis: Acute to subacute thrombosis of IJV with associated adjacent tissue inflammation (myositis and fasciitis)

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Angiographic Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Behpour-Oskooee M et al: Lemierre's syndrome with double heterozygote status in the methylenetetrahydrofolate reductase gene. World J Pediatr. 10(3):281-3, 2014
                                              2. Galyfos G et al: Septic internal jugular vein thrombosis caused by Fusobacterium necrophorum and mediated by a broken needle. Scand J Infect Dis. 46(12):911-5, 2014
                                              3. Hile LM et al: Lemierre syndrome complicating otitis externa: case report and literature review. J Emerg Med. 42(4):e77-80, 2012
                                              4. Bhatnagar P et al: Ultrasound scan in the emergency department revealed rare but potentially dangerous internal jugular vein thrombosis. Emerg Med J. 27(2):124, 2010
                                              5. Chen MH et al: Prolonged facial edema is an indicator of poor prognosis in patients with head and neck squamous cell carcinoma. Support Care Cancer. 18(10):1313-9, 2010
                                              6. Felstead AM et al: Thrombosis of the internal jugular vein: A rare but important operative finding. Br J Oral Maxillofac Surg. 48(3):195-6, 2010
                                              7. Iwata N et al: Lemierre syndrome: a Japanese patient returning from Thailand. J Infect Chemother. 16(3):213-5, 2010
                                              8. Ridgway JM et al: Lemierre syndrome: a pediatric case series and review of literature. Am J Otolaryngol. 31(1):38-45, 2010
                                              9. Binnebösel M et al: Internal jugular vein thrombosis presenting as a painful neck mass due to a spontaneous dislocated subclavian port catheter as long-term complication: a case report. Cases J. 2:7991, 2009
                                              10. Chlumský J et al: Spontaneous jugular vein thrombosis. Acta Cardiol. 64(5):689-91, 2009
                                              11. Deganello A et al: Necrotizing fasciitis of the neck associated with Lemierre syndrome. Acta Otorhinolaryngol Ital. 29(3):160-3, 2009
                                              12. Kushawaha A et al: Lemierre's syndrome, reemergence of a forgotten disease: a case report. Cases J. 2:6397, 2009
                                              13. Ball E et al: Internal jugular vein thrombosis in a warfarinised patient: a case report. J Med Case Reports. 1:184, 2007
                                              14. Ascher E et al: Morbidity and mortality associated with internal jugular vein thromboses. Vasc Endovascular Surg. 39(4):335-9, 2005
                                              15. Lin D et al: Internal jugular vein thrombosis and deep neck infection from intravenous drug use: management strategy. Laryngoscope. 114(1):56-60, 2004
                                              16. Unsal EE et al: Spontaneous internal jugular vein thrombosis associated with distant malignancies. Eur Arch Otorhinolaryngol. 260(1):39-41, 2003
                                              17. Chirinos JA et al: The evolution of Lemierre syndrome: report of 2 cases and review of the literature. Medicine (Baltimore). 81(6):458-65, 2002
                                              18. Gong J et al: Lemierre's syndrome. Eur Radiol. 9(4):672-4, 1999
                                              19. Patel MC et al: Subclavian and internal jugular veins at Doppler US: abnormal cardiac pulsatility and respiratory phasicity as a predictor of complete central occlusion. Radiology. 211(2):579-83, 1999
                                              20. Provenzale JM et al: Systemic thrombosis in patients with antiphospholipid antibodies: lesion distribution and imaging findings. AJR Am J Roentgenol. 170(2):285-90, 1998
                                              21. Quraishi HA et al: Internal jugular vein thrombosis after functional and selective neck dissection. Arch Otolaryngol Head Neck Surg. 123(9):969-73, 1997
                                              22. Sakai O et al: Asymmetrical or heterogeneous enhancement of the internal jugular veins in contrast-enhanced CT of the head and neck. Neuroradiology. 39(4):292-5, 1997
                                              23. Poe LB et al: Acute internal jugular vein thrombosis associated with pseudoabscess of the retropharyngeal space. AJNR Am J Neuroradiol. 16(4 Suppl):892-6, 1995
                                              24. Colletti PM et al: Magnetic resonance angiography of the neck veins. Magn Reson Imaging. 11(2):279-83, 1993
                                              25. Tovi F et al: Septic internal jugular vein thrombosis. J Otolaryngol. 22(6):415-20, 1993
                                              26. Ostrum DS: Thrombosis of the internal jugular vein: findings on MR and color Doppler imaging. AJR Am J Roentgenol. 157(6):1358-9, 1991
                                              27. Williams CE et al: Venous thrombosis in the neck. The role of real time ultrasound. Eur J Radiol. 9(1):32-6, 1989
                                              28. Gaitini D et al: High-resolution real-time ultrasonography. Diagnosis and follow-up of jugular and subclavian vein thrombosis. J Ultrasound Med. 7(11):621-7, 1988
                                              29. Albertyn LE et al: Diagnosis of internal jugular vein thrombosis. Radiology. 162(2):505-8, 1987
                                              30. Weissleder R et al: Sonographic diagnosis of subclavian and internal jugular vein thrombosis. J Ultrasound Med. 6(10):577-87, 1987
                                              31. Erdman WA et al: Venous thrombosis: clinical and experimental MR imaging. Radiology. 161(1):233-8, 1986
                                              32. Braun IF et al: Jugular venous thrombosis: MR imaging. Radiology. 157(2):357-60, 1985
                                              33. Cohen JP et al: Internal jugular vein thrombosis. Laryngoscope. 95(12):1478-82, 1985
                                              34. Giyanani VL et al: Computed tomography of internal jugular vein thrombosis. J Comput Tomogr. 9(1):33-7, 1985
                                              35. Wing V et al: Sonography of jugular vein thrombosis. AJR Am J Roentgenol. 140(2):333-6, 1983
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Abbreviations

                                                            • Jugular vein thrombosis (JVT)
                                                          • Definitions

                                                            • JVT: Chronic internal jugular vein (IJV) thrombosis (> 10 days after acute event) in which clot persists within lumen after soft tissue inflammation is gone
                                                            • Jugular vein thrombophlebitis: Acute to subacute thrombosis of IJV with associated adjacent tissue inflammation (myositis and fasciitis)

                                                          IMAGING

                                                          • General Features

                                                            • Radiographic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Ultrasonographic Findings

                                                                    • Angiographic Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Behpour-Oskooee M et al: Lemierre's syndrome with double heterozygote status in the methylenetetrahydrofolate reductase gene. World J Pediatr. 10(3):281-3, 2014
                                                                                          2. Galyfos G et al: Septic internal jugular vein thrombosis caused by Fusobacterium necrophorum and mediated by a broken needle. Scand J Infect Dis. 46(12):911-5, 2014
                                                                                          3. Hile LM et al: Lemierre syndrome complicating otitis externa: case report and literature review. J Emerg Med. 42(4):e77-80, 2012
                                                                                          4. Bhatnagar P et al: Ultrasound scan in the emergency department revealed rare but potentially dangerous internal jugular vein thrombosis. Emerg Med J. 27(2):124, 2010
                                                                                          5. Chen MH et al: Prolonged facial edema is an indicator of poor prognosis in patients with head and neck squamous cell carcinoma. Support Care Cancer. 18(10):1313-9, 2010
                                                                                          6. Felstead AM et al: Thrombosis of the internal jugular vein: A rare but important operative finding. Br J Oral Maxillofac Surg. 48(3):195-6, 2010
                                                                                          7. Iwata N et al: Lemierre syndrome: a Japanese patient returning from Thailand. J Infect Chemother. 16(3):213-5, 2010
                                                                                          8. Ridgway JM et al: Lemierre syndrome: a pediatric case series and review of literature. Am J Otolaryngol. 31(1):38-45, 2010
                                                                                          9. Binnebösel M et al: Internal jugular vein thrombosis presenting as a painful neck mass due to a spontaneous dislocated subclavian port catheter as long-term complication: a case report. Cases J. 2:7991, 2009
                                                                                          10. Chlumský J et al: Spontaneous jugular vein thrombosis. Acta Cardiol. 64(5):689-91, 2009
                                                                                          11. Deganello A et al: Necrotizing fasciitis of the neck associated with Lemierre syndrome. Acta Otorhinolaryngol Ital. 29(3):160-3, 2009
                                                                                          12. Kushawaha A et al: Lemierre's syndrome, reemergence of a forgotten disease: a case report. Cases J. 2:6397, 2009
                                                                                          13. Ball E et al: Internal jugular vein thrombosis in a warfarinised patient: a case report. J Med Case Reports. 1:184, 2007
                                                                                          14. Ascher E et al: Morbidity and mortality associated with internal jugular vein thromboses. Vasc Endovascular Surg. 39(4):335-9, 2005
                                                                                          15. Lin D et al: Internal jugular vein thrombosis and deep neck infection from intravenous drug use: management strategy. Laryngoscope. 114(1):56-60, 2004
                                                                                          16. Unsal EE et al: Spontaneous internal jugular vein thrombosis associated with distant malignancies. Eur Arch Otorhinolaryngol. 260(1):39-41, 2003
                                                                                          17. Chirinos JA et al: The evolution of Lemierre syndrome: report of 2 cases and review of the literature. Medicine (Baltimore). 81(6):458-65, 2002
                                                                                          18. Gong J et al: Lemierre's syndrome. Eur Radiol. 9(4):672-4, 1999
                                                                                          19. Patel MC et al: Subclavian and internal jugular veins at Doppler US: abnormal cardiac pulsatility and respiratory phasicity as a predictor of complete central occlusion. Radiology. 211(2):579-83, 1999
                                                                                          20. Provenzale JM et al: Systemic thrombosis in patients with antiphospholipid antibodies: lesion distribution and imaging findings. AJR Am J Roentgenol. 170(2):285-90, 1998
                                                                                          21. Quraishi HA et al: Internal jugular vein thrombosis after functional and selective neck dissection. Arch Otolaryngol Head Neck Surg. 123(9):969-73, 1997
                                                                                          22. Sakai O et al: Asymmetrical or heterogeneous enhancement of the internal jugular veins in contrast-enhanced CT of the head and neck. Neuroradiology. 39(4):292-5, 1997
                                                                                          23. Poe LB et al: Acute internal jugular vein thrombosis associated with pseudoabscess of the retropharyngeal space. AJNR Am J Neuroradiol. 16(4 Suppl):892-6, 1995
                                                                                          24. Colletti PM et al: Magnetic resonance angiography of the neck veins. Magn Reson Imaging. 11(2):279-83, 1993
                                                                                          25. Tovi F et al: Septic internal jugular vein thrombosis. J Otolaryngol. 22(6):415-20, 1993
                                                                                          26. Ostrum DS: Thrombosis of the internal jugular vein: findings on MR and color Doppler imaging. AJR Am J Roentgenol. 157(6):1358-9, 1991
                                                                                          27. Williams CE et al: Venous thrombosis in the neck. The role of real time ultrasound. Eur J Radiol. 9(1):32-6, 1989
                                                                                          28. Gaitini D et al: High-resolution real-time ultrasonography. Diagnosis and follow-up of jugular and subclavian vein thrombosis. J Ultrasound Med. 7(11):621-7, 1988
                                                                                          29. Albertyn LE et al: Diagnosis of internal jugular vein thrombosis. Radiology. 162(2):505-8, 1987
                                                                                          30. Weissleder R et al: Sonographic diagnosis of subclavian and internal jugular vein thrombosis. J Ultrasound Med. 6(10):577-87, 1987
                                                                                          31. Erdman WA et al: Venous thrombosis: clinical and experimental MR imaging. Radiology. 161(1):233-8, 1986
                                                                                          32. Braun IF et al: Jugular venous thrombosis: MR imaging. Radiology. 157(2):357-60, 1985
                                                                                          33. Cohen JP et al: Internal jugular vein thrombosis. Laryngoscope. 95(12):1478-82, 1985
                                                                                          34. Giyanani VL et al: Computed tomography of internal jugular vein thrombosis. J Comput Tomogr. 9(1):33-7, 1985
                                                                                          35. Wing V et al: Sonography of jugular vein thrombosis. AJR Am J Roentgenol. 140(2):333-6, 1983