Skip to main content

Advertisement

SpringerLink
Log in

High bilateral fenestration of the internal jugular vein

  • Anatomic Variations
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Duplications and fenestrations of the internal jugular vein (IJV) are rare anatomic variations. There were previously found mostly unilateral fenestrated internal jugular veins, either empty, or traversed by the spinal accessory nerves. It was documented the computed tomography angiogram of a 65 year-old female patient and bilateral high fenestrations of the IJVs were found. On both sides, the superior ends of the fenestrations were in the jugular foramina. On the right side the fenestration had 3.8 cm length and was located in front of the transverse processes of the first two cervical vertebrae. On the opposite side the fenestration had 1.5 cm length and was antero-lateral to the transverse process of the atlas vertebra. On both sides the antero-medial arms of the fenestrations received the inferior petrosal sinuses and anterior condylar veins. Such highly placed fenestrations of the IJVs should be carefully documented either preoperatively, or prior to central venous access.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Alaani A, Webster K, Pracy JP (2005) Duplication of internal jugular vein and relation to the spinal accessory nerve. Br J Oral Maxillofac Surg 43:528–531. https://doi.org/10.1016/j.bjoms.2005.03.013

    Article  CAS  PubMed  Google Scholar 

  2. Atalar MH, Altuntas EE, Kosar MI, Uysal İ (2012) Multidetector CT findings of an extraordinary fenestration of the internal jugular vein. Diagn Interv Radiol 18:164

    PubMed  Google Scholar 

  3. Bachoo I, Evans B (2014) Duplication of the lower third of the internal jugular vein–case report and surgical implications. Br J Oral Maxillofac Surg 52:461–463. https://doi.org/10.1016/j.bjoms.2014.02.021

    Article  PubMed  Google Scholar 

  4. Bathala S, Makura ZG (2015) Duplication of the right internal jugular vein: a case report. Ear Nose Throat J 94:236–237. https://doi.org/10.1177/014556131509400610

    Article  PubMed  Google Scholar 

  5. Bhoriwal S, Sharma J, Dhall K, Mandal A, Chhebbi M, Surya T (2021) Duplication of the internal jugular vein—a rare anatomical variation. Oral Oncol 112:104985. https://doi.org/10.1016/j.oraloncology.2020.104985

    Article  PubMed  Google Scholar 

  6. Biondi P, Colella G, Gherardini G, Tartaro G, Rauso R (2009) Internal jugular vein duplication. Indian J Plast Surg 42:273–274. https://doi.org/10.4103/0970-0358.59303

    Article  PubMed  PubMed Central  Google Scholar 

  7. Burman S, Pandey S, Rao S, Rao S (2021) Duplication of the internal jugular vein: a rare presentation during neck dissection. BMJ Case Rep. https://doi.org/10.1136/bcr-2020-239007

    Article  PubMed  Google Scholar 

  8. Coca Pelaz A, Rodrigo Tapia JP (2008) Bilateral duplication of the internal jugular vein. Acta Otorrinolaringol Esp 59:314

    Article  Google Scholar 

  9. Contrera KJ, Aygun N, Ward BK, Gooi Z, Richmon JD (2016) Internal jugular vein duplication and fenestration: case series and literature review. Laryngoscope 126:1585–1588. https://doi.org/10.1002/lary.25743

    Article  PubMed  Google Scholar 

  10. Cvetko E (2015) Unilateral fenestration of the internal jugular vein: a case report. Surg Radiol Anat 37:875–877

    Article  Google Scholar 

  11. Cvetko E, Meznarič M (2017) Concomitant fenestration and phlebectasia of the right internal jugular vein: a unique finding in anatomical dissection. Folia Morphol (Warsz) 76:519–522

    Article  CAS  Google Scholar 

  12. Devi Sankar K, Sharmila Bhanu P (2011) Variant anatomy of fenestrated internal jugular vein with unusual retromandibular and facial veins. Int J Anat Var 4:144–146

    Google Scholar 

  13. Downie SA, Schalop L, Mazurek JN, Savitch G, Lelonek GJ, Olson TR (2007) Bilateral duplicated internal jugular veins: case study and literature review. Clin Anat 20:260–266. https://doi.org/10.1002/ca.20366

    Article  CAS  PubMed  Google Scholar 

  14. Furnas DW (1967) Transverse process of the atlas: guide to high ligation of the internal jugular vein in radical neck dissections. Ann Surg 165:473–476. https://doi.org/10.1097/00000658-196703000-00024

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Gardiner KJ, Irvine BW, Murray A (2002) Anomalous relationship of the spinal accessory nerve to the internal jugular vein. Clin Anat 15:62–63. https://doi.org/10.1002/ca.1094

    Article  CAS  PubMed  Google Scholar 

  16. Gonzalez-Garcia R, Roman-Romero L, de la Plata MM (2007) The rare phenomenon of internal jugular vein duplication. Otolaryngol Head Neck Surg 137:847–848. https://doi.org/10.1016/j.otohns.2007.06.732

    Article  PubMed  Google Scholar 

  17. Hashimoto Y, Otsuki N, Morimoto K, Saito M, Nibu K-i (2012) Four cases of spinal accessory nerve passing through the fenestrated internal jugular vein. Surg Radiol Anat 34:373–375

    Article  Google Scholar 

  18. Hovelacque A (1923) Les nerfs craniens; anatomie macroscopique. Presses Universitaires de France, Paris

    Google Scholar 

  19. Ibrahim B, Berania I, Moubayed SP, Christopoulos A, Ayad T (2016) Internal jugular vein duplication: anatomic relationship with the spinal accessory nerve. J Oral Maxillofac Surg 74(1502):e1501-1504. https://doi.org/10.1016/j.joms.2016.03.002

    Article  Google Scholar 

  20. Kapre M, Mangalgiri AS (2012) Clinical importance of duplication of internal jugular vein. Indian J Otolaryngol Head Neck Surg 64:386–388. https://doi.org/10.1007/s12070-011-0410-8

    Article  PubMed  Google Scholar 

  21. Kayashima K, Imai K, Murashima K (2013) Internal jugular vein duplication with absent carotid sheath detected during ultrasound-guided pediatric central venous catheter placement. J Anesth 27:972–973. https://doi.org/10.1007/s00540-013-1636-2

    Article  PubMed  Google Scholar 

  22. Kumar JI, Ma S, Agarwalla P, Shimony N, Liu SS (2019) Anatomic alert: spinal accessory nerve traversing a fenestrated internal jugular vein. Br J Neurosurg 33:673–674. https://doi.org/10.1080/02688697.2019.1661969

    Article  PubMed  Google Scholar 

  23. Levy D, Vacher C, Lezy JP (2001) Relations of the accessory nerve with the internal jugular vein: surgical implications in cervical lymph node clearances. Surg Radiol Anat 23:155–157. https://doi.org/10.1007/s00276-001-0155-2

    Article  CAS  PubMed  Google Scholar 

  24. Moreno-Sanchez M, Hernandez Vila C, Gonzalez-Garcia R, Monje F (2015) Fenestrated internal jugular vein: a rare finding in neck dissection. Int J Oral Maxillofac Surg 44:1086–1087. https://doi.org/10.1016/j.ijom.2015.05.014

    Article  CAS  PubMed  Google Scholar 

  25. Mortazavi MM, Griessenauer CJ, Krishnamurthy S, Verma K, Loukas M, Tubbs RS (2014) The inferior petrosal sinus: a comprehensive review with emphasis on clinical implications. Childs Nerv Syst 30:831–834. https://doi.org/10.1007/s00381-014-2378-7

    Article  PubMed  Google Scholar 

  26. Munoz Guerra MF, Campo FR, Gias LN, Diaz Gonzalez FJ (2000) Double internal jugular vein. Plast Reconstr Surg 106:1434–1435. https://doi.org/10.1097/00006534-200011000-00050

    Article  CAS  PubMed  Google Scholar 

  27. Nayak BS (2006) Surgically important variations of the jugular veins. Cin Anat 19:544–546

    Article  Google Scholar 

  28. Ozturk NC, Talas DU (2010) Fenestration of internal jugular vein and relation to spinal accessory nerve: case report and review of the literature. Clin Anat 23:883–884. https://doi.org/10.1002/ca.20897

    Article  PubMed  Google Scholar 

  29. Park JY, Lee IH, Song CJ (2011) Fenestrated internal jugular vein: case report. J Korean Soc Radiol 64:227–229

    Article  Google Scholar 

  30. Parsons F, Keith A (1897) Seventh Report of the Committee of Collective Investigation of the Anatomical Society of Great Britain and Ireland, 1896–1897. J Anat Physiol 32:164–186

    CAS  PubMed  PubMed Central  Google Scholar 

  31. Pegot A, Guichard B, Peron JM, Trost O (2015) Empty fenestration of the internal jugular vein: a rare phenomenon. Br J Oral Maxillofac Surg 53:78–80. https://doi.org/10.1016/j.bjoms.2014.09.005

    Article  PubMed  Google Scholar 

  32. Prades JM, Timoshenko A, Dumollard JM, Durand M, Merzougui N, Martin C (2002) High duplication of the internal jugular vein: clinical incidence in the adult and surgical consequences, a report of three clinical cases. Surg Radiol Anat 24:129–132. https://doi.org/10.1007/s00276-002-0020-y

    Article  CAS  PubMed  Google Scholar 

  33. Radak D, Tanaskovic S, Marinkovic S, Antonic Z, Kolar J (2012) Internal jugular vein duplication: a further truncular malformation in a patient with multiple sclerosis. Phlebology 27:194–196. https://doi.org/10.1258/phleb.2011.011027

    Article  CAS  PubMed  Google Scholar 

  34. Radoi PM, Rusu MC, Dinca D, Toader C (2021) Combined rare anatomic variants: persistent primitive olfactory artery and azygos pericallosal artery. Surg Radiol Anat 43:1305–1308. https://doi.org/10.1007/s00276-021-02687-9

    Article  PubMed  Google Scholar 

  35. Rossi A, Tortori-Donati P (2001) Internal jugular vein phlebectasia and duplication: case report with magnetic resonance angiography features. Pediatr Radiol 31:134. https://doi.org/10.1007/s002470000350

    Article  CAS  PubMed  Google Scholar 

  36. Rusu MC, Maru N, Radoi PM, Dinca D (2019) Trifurcated external carotid artery and complete gamma-loop of its maxillary branch. Surg Radiol Anat 41:231–234. https://doi.org/10.1007/s00276-018-2142-x

    Article  PubMed  Google Scholar 

  37. Sheen TS, Chung TT, Snyderman CH (1997) Transverse process of the atlas(C1)–an important surgical landmark of the upper neck. Head Neck 19:37–40. https://doi.org/10.1002/(sici)1097-0347(199701)19:1%3c37::aid-hed7%3e3.0.co;2-w

    Article  CAS  PubMed  Google Scholar 

  38. Sidana S, Ahuja S (2016) Re: Empty fenestration of the internal jugular vein: a rare phenomenon. Br J Oral Maxillofac Surg 54:477. https://doi.org/10.1016/j.bjoms.2015.07.007

    Article  CAS  PubMed  Google Scholar 

  39. Som PM, Shugar JM, Sacher M, Lanzieri CF (1985) Internal jugular vein phlebectasia and duplication: CT features. J Comput Assist Tomogr 9:390–392. https://doi.org/10.1097/00004728-198503000-00035

    Article  CAS  PubMed  Google Scholar 

  40. Sylaidis P, Bardsley A, Montgomery P (1997) Duplication of internal jugular vein. Arch Otolaryngol Head Neck Surg 123:1358. https://doi.org/10.1001/archotol.1997.01900120108019

    Article  CAS  PubMed  Google Scholar 

  41. Tandler J (1907) Die Entwickelung der Lagebeiziehung zwishen Nervus accessorius und der vena jugularis interna beim Menschen. AnatAnz XXXI.

  42. Thakur JS, Sharma DR, Mohindroo NK (2012) Double fenestration of the internal jugular vein: a rare anatomic variant. Ear Nose Throat J 91:420–427

    Article  Google Scholar 

  43. Torres US, Teixeira AC, Sanches RA (2014) Fenestrated internal jugular vein: diagnosis by multidetector CT. J Vasc Interv Radiol 25:152–153. https://doi.org/10.1016/j.jvir.2013.10.015

    Article  PubMed  Google Scholar 

  44. Towbin AJ, Kanal E (2004) A review of two cases of fenestrated internal jugular veins as seen by CT angiography. AJNR Am J Neuroradiol 25:1433–1434

    PubMed  PubMed Central  Google Scholar 

  45. Turan-Ozdemir S, Coskun H, Balban M (2004) Phlebectasia of the external jugular vein associated with duplication of the internal jugular vein. Clin Anat 17:522–525. https://doi.org/10.1002/ca.10253

    Article  CAS  PubMed  Google Scholar 

  46. Uemura M, Takemura A, Tamada Y, Toda I, Ike H, Suwa F (2006) A case of right partial and double internal jugular veins. Anat Sci Int 81:65–69. https://doi.org/10.1111/j.1447-073X.2006.00119.x

    Article  PubMed  Google Scholar 

  47. Verma AK, Puri SK, Sethi S, Jain N (2015) Duplication of internal jugular vein: a rare venous anomaly. Int J Anat Res 3:1109–1110

    Google Scholar 

  48. Wang X, Peng L, Guo H, Hernesniemi J, Xiong X, Andrade-Barazarte H, Qian R (2020) Internal jugular vein fenestration and duplication: anatomical findings, prevalence, and literature review. Front Surg 7:593367. https://doi.org/10.3389/fsurg.2020.593367

    Article  PubMed  PubMed Central  Google Scholar 

  49. Wong BY, Strachan DR, Loney EL (2010) Duplication of internal jugular veins: case report. J Laryngol Otol 124:341–344. https://doi.org/10.1017/S0022215109990855

    Article  CAS  PubMed  Google Scholar 

  50. Zhang WG, Ye YY, Chen JH, Chen R, Kuang LQ, Li X (2010) Imaging study of the long extracranial extension of the inferior petrosal sinus with MSCT. Clin Anat 23:160–167. https://doi.org/10.1002/ca.20907

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Anatomy, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 8 Eroilor Sanitari Blvd, 050474, Bucharest, Romania

    Mugurel Constantin Rusu & Alexandra Diana Vrapciu

  2. Department 11 of Plastic and Reconstructive Surgery and Pediatric Surgery, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

    Șerban Arghir Popescu

Authors
  1. Mugurel Constantin Rusu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alexandra Diana Vrapciu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Șerban Arghir Popescu
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

MCR: protocol/project development, data analysis, documented specific literature, approved the final version of manuscript. ADV: data analysis, reviewed the manuscript, contributed discussions. ȘAP: data analysis, reviewed the literature, reviewed the manuscript.

Corresponding author

Correspondence to Alexandra Diana Vrapciu.

Ethics declarations

Conflict of interests

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

276_2022_2931_MOESM1_ESM.tif

Online Resource 1. Axial cut through the upper ends of the fenestrated internal jugular veins. 1, 1’. Internal carotid artery; 2, 2’. Inferior petrosal sinus; 3, 3’. Anterior condylar vein; 4, 4’. Antero-medial arm of the fenestrated internal jugular vein; 5, 5’. Postero-lateral arm of the fenestrated internal jugular vein (TIF 739 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rusu, M.C., Vrapciu, A.D. & Popescu, Ș.A. High bilateral fenestration of the internal jugular vein. Surg Radiol Anat 44, 703–708 (2022). https://doi.org/10.1007/s00276-022-02931-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-022-02931-w

Keywords

Search

Navigation