What does jugular vein mean? Jugular vein in the neck. Possible complications and their prevention

The jugular vein is a group of veins located in the neck, the main function of which is to circulate blood from the head and neck to the lower extremities. The jugular vein includes the internal, external and anterior veins, which differ from each other in location, size and purpose.

Internal jugular vein

The main function of the internal jugular vein is to collect blood and carbon dioxide from the superior region and transfer it to the vena cava.

Has two ducts:

• intracranial;
• extracranial.

Two veins serve as intracranial ducts: diploic And emissary. Diploic veins are located in diploic canals, hence the names. They are differentiated by location into frontal, anterior, posterior, and occipital.

Emissary veins are veins whose main function is to connect the veins on the outside of the skull with the veins on the inside.

Thanks to the intracranial ducts, blood flows from the sinuses of the brain to the jugular vein.

The extracranial ducts are the pharyngeal veins, the mandibular veins, the esophagus
venous veins, thyroid veins.

External jugular vein- a vein through which blood flows from the head to the heart. It is small in size. It becomes noticeable visually and upon palpation, when laughing, coughing and singing.

Consists of two venous trunks. One of them is the connection of the external extracranial jugular vein and its tributary behind the mandibular vein.

The external jugular vein has several branch veins: occipital, suprascapular, transverse, anterior jugular vein.

Anterior jugular vein

Consists of the veins of the sublingual region, carries blood flow to the subclavian vein. Differs in small sizes.

Phlebitis is an inflammatory process in the venous wall.

There are several reasons for the occurrence of this disease, the main ones are:

1. Problems with KCL injections.
   This leads to the fact that the injected composition does not enter the vein itself, but into the area nearby. Inflammation forms in damaged tissues, which causes phlebitis.
2. Neglecting disinfection of medical devices that come into contact with a vein, such as injection syringes and catheters.
   Phlebitis occurs as a consequence of injuries, wounds and other damage.
3. Chemical burn.
   Common among drug addicts, especially when intravenously administered opiate-containing substances.

Phlebitis as a consequence of an abscess

An abscess is a process of tissue suppuration, which is localized in the muscles, under the skin, and in organs due to infection.

Symptoms:

• It begins with a pronounced clinical picture: high temperature, fever, chills appear, pain appears throughout the body, the patient cannot determine the exact location of the pain, which makes it difficult to diagnose phlebitis, headache and dizziness appear, accompanied by vomiting.

Diagnostics

Phlebitis is diagnosed as follows:

• Ultrasound scanning of veins is a procedure, which consists of examining the condition of the veins, indicated for suspected phlebitis. It allows you to see a complete picture of the state of blood flow in the jugular vein, which helps to identify pathologies and disorders that occur with phlebitis and make an accurate diagnosis.

Treatment

Treatment is selected depending on the causes of phlebitis:

1. if the cause of jugular vein phlebitis is infection, in this case, the following drugs from the antibiotic group are prescribed: cephalosporins, tetracyclines. It should be remembered that when taking tetracyclines, the diet is adjusted and dairy products are excluded.
2. drugs to increase blood flow. For more effective results, such drugs are used in several forms of release simultaneously, that is, tablets for oral administration are usually combined with external ointments. The most popular in terms of frequency of prescription is troxyvosin. It must be used orally in the form of capsule-shaped tablets and topically in the form of a gel.

Possible complications

With timely and adequate treatment, complete recovery occurs a month after the onset of phlebitis. In the absence of qualified medical care, a number of complications can occur.

Very often, advanced phlebitis causes the development of thrombophlebitis, a dangerous disease that increases the risk of thrombosis.

In addition, a purulent process can often begin in the area of ​​inflammation of the vein. This is why it is so important to seek medical help if you have symptoms of phlebitis. A phlebologist treats and diagnoses phlebitis.

Jugular vein thrombosis in the neck

Causes:

• Some chronic, especially autoimmune diseases, cause thrombosis, for example systemic lupus erythematosus and antiphospholipid syndrome.
• Cancerous tumors and methods of their treatment, such as chemotherapy, trigger a number of pathological changes in the body, leading to thrombosis.
• Women who take oral contraceptives, are most susceptible to thrombosis. For this reason, OK can only be prescribed by a gynecologist after a complete examination. Also, taking hormonal contraceptives is contraindicated for women who smoke and suffer from venous diseases.
• Staying in one position for a long time promotes blood thickening and thrombosis. During air travel, during sedentary work, the body is immobilized for a long time, which contributes to the formation of blood clots.
• Phlebitis and other diseases in an advanced stage they become the cause of thrombosis.

Symptoms:

1. The first and most common symptom of jugular vein thrombosis is a sharp pain in the neck that gets worse when turning the head.
2. Also, in the area of ​​the jugular vein, swelling appears on the skin, the jugular vein enlarges, and the veins themselves become noticeable, visible to the light.
3. Due to damage to the optic nerve, vision deteriorates sharply, the patient feels weak, and aching pain appears in the arms and legs.
4. Then either blood poisoning develops or there is a risk of a blood clot breaking off.
5. The detached thrombus, along with the blood flow, enters the lungs and leads to pulmonary embolism.

Diagnostics

The diagnosis of thrombosis is made based on the patient's symptoms and the results of a number of diagnostic methods.

If the symptoms described above appear, you must call an ambulance, since thrombosis can cause conditions incompatible with life. Differentiating thrombosis from other diseases is quite a difficult task, since these symptoms are common in many other vascular pathologies.

To make an accurate diagnosis, the following studies are carried out:

1. Thrombodynamics test.
   A method that allows you to determine the level of blood clotting. To conduct laboratory tests, the patient's venous blood is required. It is considered a highly sensitive method for detecting circulatory pathologies.
2. TV test.
   Allows you to diagnose the stages of blood clotting and determine disturbances in the rate of fibrin formation.
3. MRI– tomographic examination, allowing to deeply study the condition of the jugular vein.

Treatment

The treatment method is selected depending on the patient’s condition. There are surgical, medicinal, coagulant methods of treating thrombosis.

Possible complications

The most severe condition that causes thrombosis is thromboembolism, it almost always ends in death. Embolism causes myocardial infarction and stroke.

Causes:

1. Excessive stress on the body.
   The causes of vascular disorders, including ectasia, can most often be heavy stress on the body, such as professional sports, exhausting study or work, all of which affects the cardiovascular system, and therefore directly affects blood circulation and the condition of blood vessels.
2. Violation of the work and rest regime.
   Lack of adequate sleep, long working hours, and night work cause a large number of diseases, including affecting the condition of blood vessels.
3. Hormonal imbalance
   uncontrolled use of hormonal drugs, bad habits, strict diets disrupt a person’s hormonal levels, and, therefore, the functioning of the entire body.
4. Vascular dysfunction due to spinal injuries.

Symptoms:

The presence of swelling in the neck is the first and main sign of phlebectasia. This is an enlarged vessel, which in the early stages of the disease does not cause discomfort or any pain.

Over time, ectasia will begin to progress, causing compressive pain in the neck, as well as changes in the voice, hoarseness may appear, and breathing problems are often observed.

Treatment:

• Treatment depends on the severity of the disease.
• At an advanced stage treatment in a hospital setting is indicated. In rare cases, when the course is particularly severe, surgical intervention is performed; most often, treatment of ectasia is limited to drug therapy.
• In the treatment of vascular ectasia of the jugular vein Most often, drugs to normalize the functioning of blood vessels, such as thrombo ass and phlegm 600, are combined with injections of trental and antovengin to improve blood circulation.

Possible complications

A complete cure is only possible if ectasia is diagnosed and treated at the very beginning of the disease, so it is important to seek medical help if a person has symptoms resembling jugular vein ectasia.

Jugular vein in a child

Many parents are concerned when they discover that their child's jugular vein in the neck is distended, especially when laughing or crying. Most often, the cause of this deviation is the above-described phlebectasia.

Most often, jugular vein aneurysm in children is a congenital pathology.

Treatment is no different from the adult course. The only thing is that in the case of children, surgical treatment is most often used.

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The jugular vein is a blood vein that is responsible for the process of blood circulation from the brain to the cervical region. In certain areas of the brain, the blood absorbs carbon dioxide and various toxic substances. The jugular vein delivers unpurified blood to the heart for filtering. It is the proximity of the vein to such an important human organ that prompts us to take seriously any changes in its functioning.

Therefore, if the jugular vein in the neck is dilated, examination and therapy are required after the exact causes of the pathology are established.

Phlebectasia, or dilatation of the jugular vein, is a disruption of the functioning of blood vessels and valves. Vascular valves cease to regulate the flow of venous blood. The blood, in turn, begins to accumulate, forming clots. A large number of them causes a process of dysfunction in the functioning of almost the entire venous network of the body. Normal blood circulation stops and the person becomes ill.

This condition largely depends on the anatomical structure of the veins.

Anatomical structure

Each of the jugular veins is divided into anterior, external and internal and has its own location:

• The internal jugular vein stretches from the base of the skull and ends near the subclavian fossa. There she pours venous blood, which comes from the skull, into the large brachiocephalic vessel.
• The beginning of the external jugular vein is located under the auricle. From this point it descends down the upper part of the sternoclavicular muscle. Having reached its posterior edge, it penetrates the vessels of the internal jugular and subclavian veins. The external vessel has many branches and valves.
• The anterior jugular vein is initially located on the outer surface of the mylohyoid muscle, moves along the sternothyroid muscle and passes near the midline of the neck. It enters the external and subclavian jugular veins, forming an anastomosis.

The anterior jugular vein is very small and forms a pair of vessels, that is, it is paired.

Symptoms

If the jugular veins are even slightly dilated, then specific signs appear indicating pathology. They depend on the stage of the disease:

• Stage 1. A slight swelling (enlargement) in the neck that does not cause discomfort or pain. Determined during a visual inspection.
• Stage 2 . Pulling pain and the appearance of increased intravenous pressure with rapid movement and sudden turns of the head.
• Stage 3 . The pain is sharp, intense, there is hoarseness and difficulty breathing.

If the internal jugular vein expands, serious disruptions occur in the functioning of the circulatory system. This situation requires a thorough diagnosis of the causes of the pathology and comprehensive treatment.

Causes

Phlebectasia has no time limits and occurs in both adults and children.

Causes of dilatation of the jugular vein in the neck:

1. Injured ribs, cervical spine, spine, which provoke stagnation of venous blood.
2. Concussion, osteochondrosis.
3. Dysfunction of the cardiovascular system - heart failure, hypertension, ischemia.
4. Endocrine disorders.
5. Sedentary work for long periods of time.
6. Tumors of different ethnogenesis (benign and malignant).

It takes time and accompanying factors for pathology to occur. Therefore, it is very important to identify it early, since the disease leads to disruption of the valves.

Predisposing factors

Cervical varicose veins occur in every third inhabitant of the planet. But for the development of pathology, predisposing factors are needed:

• natural lack of connective tissue development;
• restructuring of the hormonal system;
• spinal and back injuries;
• passive lifestyle;
• poor nutrition.

The hormonal factor concerns women more. During puberty and pregnancy, there is a risk of vein swelling.

Also important factors in the occurrence of phlebectasis are stress and nervous breakdowns. The neck veins have nerve endings. In normal condition, they form elastic venous vessels. But as soon as a person gets nervous, the pressure in the veins increases and elasticity is lost.

Alcohol, smoking, toxins, and excessive physical and mental stress negatively affect the normal circulation of venous blood.

Diagnosis of phlebectasia

If the dilatation of the jugular vein is in the first stage, then a visual examination by a doctor is quite sufficient. In the second and third stages of the disease, more serious studies are used.

To make a diagnosis when pain and blood circulation problems occur, laboratory tests are used - a general blood test and instrumental tests. Instrumental ones include:

• Ultrasound or computed tomography of the cervical, thoracic and skull.
• Diagnostic puncture.
• MRI with contrast agent.
• Doppler ultrasound of neck vessels.

These are the main diagnostic methods that are used to make a final medical opinion.

In certain situations, it is better to diagnose phlebitis with the help of a tandem of doctors of various specializations (therapist, neurologist, vascular surgeon, cardiologist, endocrinologist, oncologist). This allows you to prescribe more precise conservative treatment.

Treatment of pathology

Treatment depends on the expansion of the internal jugular vein on the right or internal on the left, the results of the tests performed, and the degree of influence of the disorders on the entire body. Often, during one therapeutic complex, not only varicose veins are cured, but also other physiological disorders.

The occurrence of expansion on the right does not pose a particular threat to the patient. The pathology on the left side is much more dangerous. This is due to the impossibility of a thorough diagnosis due to the risk of damage to the lymphatic system.

A therapeutic course of medications relieves inflammation, removes swelling, and strengthens blood vessels. With long-term administration of the drug, the installation of a venous catheter is practiced.

At the third stage of the disease, surgical intervention is indispensable. The affected areas of the vein are surgically removed, and healthy ones are connected into one vessel.

Possible complications and their prevention

To avoid complications when an enlargement of the jugular vein appears in the neck, early diagnosis and serious treatment are necessary. If the process enters the uncontrolled phase, there is a threat of rupture of the affected area and death.

The development of the disease is influenced by the patient’s lifestyle, heredity and the above reasons. Only a healthy lifestyle and proper nutrition lead to the fact that blood that is not very polluted enters the brain.

Phlebectasia in children

Vein enlargement occurs at any age. But it is more dangerous for children. Most often, phlebectasia in a child is detected at birth, but cases of pathology appearing at the age of 3–5 years are not uncommon.

The main symptomatic indicators: tumor formation, dilated blood vessels, increased temperature.

The treatment uses approaches used for the recovery of adults. The only difference is that phlebectasia in children is most often treated through surgery.

Jugular vein thrombosis in the neck

Thrombosis, or the appearance of a blood clot inside a vessel, forms mainly in the presence of chronic diseases in the body. If a blood clot appears in a vessel, there is a danger of it breaking off and blocking vital arteries.

In this case, the doctor suggests taking anticoagulants - heparin and fibrinolysin. To relieve inflammation, relax muscles and thin the blood, and, consequently, to resolve a blood clot, the administration of nicotinic acid, antispasmodics, and venotonics is prescribed. The operation is rarely used.

Contraindications and prevention

People suffering from pathology and having a hereditary predisposition to it are contraindicated:

• sedentary work and vice versa - excessive physical activity;
• frequent stressful situations;
• bad habits;
• ignoring chronic diseases;
• consumption of fatty, spicy, smoked foods, canned food, sweet carbonated drinks.

To prevent jugular vein phlebectasis from occurring, it is advisable to take preventive measures. The main preventive measures are:

• regular medical examination;
• avoiding stressful situations and physical activity;
• timely removal of small enlargements using special ointments;
• treatment of chronic diseases;
• healthy lifestyle.

On the human neck there are several paired jugular veins that drain venous blood from the brain; each of these vessels has its own structural features. The internal jugular vein originates from the jugular fossa at the temporal bone of the head. In this place is the superior bulb of the jugular vein (in Latin, bulbus venae jugularis superior), which is an expansion of the vessel. Any disturbance in the location or change in the size of the jugular vein bulb can provoke the development of serious diseases that will require urgent treatment.

Possible pathologies

Many vital processes occurring in the body depend on the condition of the superior bulb of the jugular vein.

Most often, this section of the vessel undergoes two pathological changes:

1. excessive expansion and high location of the jugular vein bulb;
2. blockage of a vessel.

When the bulb expands and is located high, the functions of the inner ear may be disrupted and hearing loss may develop, which increases with increased intracranial pressure. Blocked veins provoke circulatory problems, which can result in brain damage. Both pathological processes are dangerous to human life and health.

If you suspect diseases associated with the jugular vein and other vessels, you should contact a surgeon or phlebologist. The attending physician will conduct an examination, make a diagnosis and select the appropriate treatment.

Symptoms

If the jugular vein bulb is damaged, a sick person may experience the following symptoms:

• swelling in the neck area;
• swelling of blood vessels;
• increase in local temperature in the damaged area;
• redness or blueness of the skin on the neck;
• hearing impairment;
• loss of voice;
• breathing problems;
• pain that appears when palpating the neck, turning the head, etc.

Causes

There are many reasons that provoke pathological changes in the jugular vein bulb.

Most often, the condition of blood vessels worsens under the influence of the following factors:

• recent chemotherapy;
• taking hormonal medications;
• injuries and mechanical damage to the neck;
• tumors;
• infectious diseases;
• osteochondrosis of the cervical spine;
• cardiovascular diseases;
• high blood pressure;
• blood clotting disorder;
• intoxication, etc.

Diagnostic methods

Various studies help identify vascular diseases. Most often, sick people need to undergo several examinations at once to get an accurate result.

The following will help to diagnose the pathological condition of the jugular vein and its bulb:

• Ultrasound of the neck;
• duplex scanning;
• MRI and CT;
• radiography;
• phlebography;
• puncture, etc.

Treatment

Only a doctor who is highly qualified and experienced in working with vascular pathologies can treat diseases associated with dilation or narrowing of veins. Treatment methods for such diseases are selected in accordance with the diagnosis.

Most often, patients are prescribed:

• anti-inflammatory and antispasmodic drugs;
• agents that reduce swelling;
• immunomodeling complexes;
• drugs that reduce blood viscosity and thickness;
• medications that tonic the walls of blood vessels.

In most cases, drug therapy gives a good effect, but there are situations when it is simply impossible to manage with tablets, injections and ointments alone. For patients whose disease is very severe and threatens serious consequences, operations are usually prescribed, during which the doctor will remove the blood clot or the affected area of ​​the vessel.

Such procedures help normalize the condition of not only the jugular veins, but also other vascular branches. Sometimes surgery is the only way to save a person's life.

In custody

The bulbs of the jugular veins, like the vessels themselves, play an important role in the body’s blood circulation. Any deviations and changes in the structure of blood vessels can lead to the development of diseases of internal organs and a deterioration in a person’s quality of life. To prevent such unpleasant consequences, you need to monitor the condition of the veins and, if necessary, seek medical help.

JUGULAR VEINS (venae jugulares)- paired veins that drain blood from the organs of the head and neck into the brachiocephalic veins, which, in turn, flow into the superior vena cava. The jugular veins collect blood from organs and tissues, the blood supply of which is carried out primarily from the carotid and vertebral artery systems. There is a deeply located, wider internal jugular vein (v. jugularis int.), a superficial external (posterior) jugular vein (v. jugularis ext.) and an anterior jugular vein (v. jugularis ant.). A great contribution to the study of the anatomy of the jugular veins was made by M. A. Tikhomirov, A. S. Vishnevsky, A. N. Maksimenkova V. M. Romankevich and others.

In fish, amphibians and reptiles, blood flows from the head through the anterior cardinal, or jugular, veins. In mammals, in the head and neck area, in addition to the deep veins, large saphenous veins appear, which transform into the external and anterior jugular veins.

In human ontogenesis, the internal jugular veins develop from the anterior sections of the cardinal veins, which are formed in the embryo when the veins of the head merge (vv. capitis). The external and anterior jugular veins are formed later from small vessels in the maxillary and submandibular regions. At the 8th week of development, the left anterior cardinal vein connects with the right cardinal vein through an anastomosis, which subsequently turns into the left brachiocephalic vein. The section of the right cardinal vein from the junction of the right subclavian and internal jugular veins to the indicated anastomosis gives rise to the right brachiocephalic vein.

The internal jugular vein drains blood from the brain and its membranes, the eye and tissues of the orbit, the walls of the skull and the nasal cavity, pharynx, tongue and other organs of the head and neck. It begins in the jugular foramen of the skull, being a continuation of the sigmoid sinus of the dura mater of the brain (color. Fig. 8). The upper part of the vein has an extension - the superior bulb of the internal jugular vein (bulbus venae jugularis superior).

At the junction with the subclavian vein, the internal jugular vein forms a second, larger extension - the inferior bulb of the internal jugular vein (bulbus venae jugularis inferior). On its way down, the vein passes behind the internal carotid artery, then to the side of it, and in the lower neck - lateral to the common carotid artery. The vagus nerve (n. vagus) is located behind and medial to the vein. The common carotid artery, vagus nerve and internal jugular vein form a neurovascular bundle surrounded by a connective tissue vagina (vagina carotica).

The internal jugular vein has 2-3 valves, one of which is located downward from the inferior bulb of the internal jugular vein. The right internal jugular vein is usually wider than the left. The tributaries of the internal jugular vein are divided into intracranial and extracranial. The first include the sinuses of the dura mater and the cochlear canaliculus vein (v. canaliculi cochleae). Outside the cranial cavity, the pharyngeal veins (vv. pha-ryngeae), meningeal veins (vv. meningeae), lingual vein (v. lingua-lis), superior laryngeal vein (v. laryngea superior), superior and middle thyroid veins flow into the internal jugular vein veins (vv. thyroi-deae superior et medii), sternocleidomastoid veins (vv. sternocleidomastoideae). The diameter of the internal jugular vein, the topography of its tributaries and anastomoses with other jugular veins can vary widely (color fig. 10-11). The superior and inferior extensions of the internal jugular vein are sometimes absent. In the presence of a large anterior jugular vein, the left internal jugular vein has a small diameter. Most often, the internal jugular vein anastomoses in the occipital region with tributaries of the subclavian vein, with the deep veins of the neck and vertebral veins, with the deep and superficial veins of the back. In 1949, A. S. Vishnevsky and A. N. Makeimenkov established that the variants of the internal jugular vein and its tributaries are determined by the degree of restructuring of the primary venous network in the neck.

The external jugular vein is the largest superficial vessel in the neck, through which blood flows from the skin, subcutaneous tissue and muscles of the occipital and mastoid (posterior) areas of the head, from the tissues of the deep temporal region, face, anterior and posterolateral parts of the neck. The external jugular vein is formed under the auricle at the level of the angle of the mandible at the confluence of the posterior auricular vein (v. auricularis post.), formed from the mastoid emissary vein (v. emissaria mastoidea) and the occipital vein (v. occipitalis), with the mandibular vein (v retromandibularis). The external jugular vein then runs down the outer surface of the sternocleidomastoid muscle, located directly under the saphenous muscle of the neck. Approximately in the middle of the sternocleidomastoid muscle, the external jugular vein reaches its outer edge and, in the area of ​​the angle formed by the outer edge of this muscle and the clavicle, goes deep under the lower belly of the omohyoid muscle. At this point, the external jugular vein pierces the superficial and pretracheal plates of the cervical fascia and flows into the subclavian vein, or into the internal jugular vein, or into the angle formed by the connection of these veins (venous angle). Along its route, the transverse veins of the neck (vv. transversae colli) and the suprascapular vein (v. suprascapularis), which are formed in the area of ​​branching of the arteries of the same name, flow into the external jugular vein, as well as the anterior jugular vein, which drains blood from the anterior region of the neck ( color Fig. 9). In some cases, the external jugular vein has a scattered type of formation, in which the saphenous veins in the neck form a wide-loop network, abundantly anastomosing with the tributaries of the subclavian, internal jugular and other deep veins of the neck. In others, the external as well as the anterior jugular vein are large venous vessels with a small number of anastomoses between them.

The anterior jugular vein is the largest tributary of the external jugular vein. It is formed from the subcutaneous veins of the mental region, anastomosing with the tributaries of the facial vein. Next, the anterior jugular vein runs down the side of the anterior midline of the neck, first along the outer surface of the mylohyoid muscle, and then along the sternohyoid muscle. 3-4 cm above the jugular notch of the sternum, the vein pierces the superficial plate of the cervical fascia, penetrates the suprasternal interfascial space, turns sharply laterally, pierces the pretracheal layer of the cervical fascia and flows into the external jugular vein. The anterior jugular vein rarely flows into the subclavian and brachiocephalic veins. In the suprasternal interfascial space, the right and left anterior jugular veins are connected by a transverse anastomosis, which, together with the distal segments of the anterior jugular veins located in this gap, forms a downward open jugular venous arch (arcus venosus juguli). Sometimes a network-like structure of the anterior jugular vein is observed. In these cases, one or both anterior jugular veins are poorly developed, and the superficial veins of the anterior neck are represented by numerous thin, abundantly anastomosing venous vessels. Sometimes in front of the neck there is one unpaired (median) vein, which can flow into the right or left external jugular vein, into the subclavian or into the left brachiocephalic vein.

Pathology of the jugular vein

Pathology of the jugular vein includes malformations, diseases and injuries.

Developmental defects. Among the malformations of the jugular veins, ectasia and aneurysms (especially the internal jugular vein), usually caused by a malformation of the vein wall or its valves, are more common. Less commonly, this pathology is associated with extravasal compression of the vein. As a rule, the first to pay attention to congenital pathology of the jugular veins are parents, who notice that when the child cries or screams, a tumor-like formation appears on his neck. This formation also appears or increases with straining, bending the torso forward and quickly disappears or significantly decreases in size when the tension stops or the patient’s torso straightens. On palpation, the tumor-like formation has a soft-elastic consistency and decreases with pressure. Ectasia of the external jugular vein is usually located lateral to the sternocleidomastoid muscle in the supraclavicular region; aneurysm of the internal jugular vein is localized medially or under the sternocleidomastoid muscle.

The diagnosis in typical cases can be established already during examination and testing with straining, in which significant bulging of the altered sections of the jugular vein is noted. Special research methods are used, such as ultrasound flowmetry and ultrasound angiography (see Ultrasound diagnostics), which make it possible to determine the diameter of its lumen and the speed of blood flow without puncture of the vessel. Similar information can be obtained by angioscintigraphy after intravenous administration of a radiopharmaceutical drug, the radiation of which is recorded using a special gamma camera equipped with a computer device. An increase in the diameter of the vein can also be determined by computed tomography (see Computed tomography) and emission tomography. A detailed topical picture of the lesion can be obtained by phlebography (see). To carry it out, the femoral vein is catheterized according to Seldinger and the catheter is inserted into the internal jugular vein, but it is also possible to insert a catheter through the subclavian vein (see Puncture catheterization of veins). When performing a straining test, a radiopaque substance is injected and an X-ray of the neck area is performed.

Ectasia or aneurysm of the jugular vein should be differentiated from other vascular lesions - hemangioma (see), lymphangioma (see), arterial or arteriovenous aneurysm (see), pathological tortuosity of the carotid artery or brachiocephalic trunk. On palpation, these formations have a high density, and a distinct pulsation is noted above the formations of arterial origin. In addition, with the help of ultrasound, in the listed diseases, partitions or additional inclusions in the lumen of the pathological focus can be identified, and its wall is usually thicker. The diagnosis is clarified using angiography (see). In differential diagnosis with lateral neck cyst (see), paraganglioma (see) and lymphadenitis (see), it should be taken into account that these formations do not change their shape when the patient’s body position changes and when straining. On palpation, these formations usually have a high density and there is no pulsation. In doubtful cases, they resort to ultrasound, radioisotope and angiographic studies.

With an increase in the size of the area of ​​ectasia or aneurysm of the jugular vein, caused by irreversible morphol. changes in the vessel wall, as well as in case of danger of complications (thrombosis, rupture of aneurysm) and significant cosmetic defect, surgical treatment is resorted to. Previously, for an aneurysm of the external jugular vein, resection was performed, and for an aneurysm of the internal jugular vein, it was wrapped, lateral excision, or sutured on the vein wall. In the crust, it is believed that the most effective radical operation is resection of the aneurysm with end-to-end anastomosis. With timely treatment, the prognosis is usually favorable.

Diseases. Among acquired diseases, thrombophlebitis (see), thrombosis (see) and secondary occlusion of the jugular vein as a result of compression of the vein or tumor growth into it are of greatest importance.

Thrombophlebitis of the jugular vein can occur with prolonged catheterization of the veins, as well as after acute periphlebitis (see Phlebitis) with tonsillitis (see), otitis (see) or retropharyngeal abscess (see). Patients complain of pain along the vein, sometimes difficulty swallowing. In the case of thrombophlebitis of the external jugular vein, hyperemia of the skin along the vein is noted; upon palpation, a painful compaction is detected in the projection of the vessel. Acute purulent thrombophlebitis of the internal jugular vein is accompanied by high body temperature and chills. Mobility of the head and neck is limited due to pain and swelling of the tissues of the lateral surface of the neck. Palpation reveals sharp pain along the sternocleidomastoid muscle. The diagnosis is clarified using ultrasound and angioscintigraphy.

Occlusion of the internal jugular vein as a result of gradually increasing thrombosis or compression by a tumor is accompanied by swelling of the corresponding half of the face and neck. Swelling is usually pronounced in the morning and in cases where the patient lies on the affected side. If occlusion of the jugular vein extends to the facial and ophthalmic veins, exophthalmos develops with swelling of the eyelids. Thanks to the developed collateral connections between the internal and external jugular veins, as well as between these veins and the veins of the opposite side of the neck, unilateral occlusion of the internal jugular vein is usually quickly compensated and never leads to severe circulatory disorders. The prognosis is generally determined by the underlying disease.

Treatment of thrombophlebitis of the jugular veins is carried out with anti-inflammatory drugs and antibiotics. At the same time, infusions of rheopolyglucin with trental are indicated, and heparin, venoruton ointments or chirudoid are used topically. The prognosis with timely treatment is usually favorable.

Injuries to the jugular veins - see Blood vessels. If the external jugular vein is damaged, it can be ligated without fear of developing any complications. If the internal jugular vein is damaged, its integrity is restored by applying a vascular suture (see) or, if necessary, part of the vessel is resected and an end-to-end anastomosis is applied. To perform such an intervention, wide mobilization of the vein is necessary. The patient should be in a position with the head adducted as much as possible; The anastomosis is performed with a monofilament thread on an atraumatic needle. The prognosis after technically correctly performed surgical interventions on the jugular veins is usually good.

Bibliography: Vishnevsky A. S. and Maksimenkov A. N. Atlas of the peripheral nervous and venous systems, M., 1949; Debt o-S and b at r about in B. A. Anastomoses and ways of roundabout circulation in humans, L., 1956; Pokrovsky A. V. Clinical angiology, M., 1979; Romankevich V. M. Differences in the structure of the external jugular veins, Sat. scientific works Bashkirsk. honey. Institute, vol. 11, p. 107, Ufa, 1959; Tikhomirov M. A. Variations of arteries and veins of the human body in connection with the morphology of the circulatory vascular system, Kyiv, 1900; Private surgery of heart and vascular diseases, ed. V. I. Burakovsky and S. A. Kolesnikov, M., 1967; Venous problems, ed. by J. J. Bergan a. J. S. T. Yao, Chicago-L., 1978.

A. V. Pokrovsky (pathology), M. P. Sapin (an.).

Diseases of the cardiovascular system rank first among body pathologies among the population of the entire globe. Not the least of these pathologies is the expansion of the jugular vein in the neck. By determining the cause of the disease, you can correct its development, avoid unpleasant symptoms and consequences that may arise in the absence of treatment. In order to correctly determine the cause of the disease, it is necessary not only to consult a doctor, but also to correctly determine the condition and possible consequences.

Features of the disease

Dilatation of the jugular vein is called phlebectasia. Such conditions can arise as a result of malfunction of the valves located throughout the vein. For many reasons, the valves can no longer regulate the flow of venous blood; it accumulates in large quantities in the vessel, stretching its walls and disabling more and more valves.

Another important factor is the discharge of blood from the veins located deep under the muscles into the superficial veins. This non-physiological redistribution of blood, due to a number of reasons, causes dysfunction in the entire venous network, also leading to vasodilation.

The jugular vein consists of several branches - a pair of internal vessels, external and anterior. These vessels perform an important function in the functioning of the body - they carry blood away from the brain and cervical spine. It is its close location to the brain that makes us take seriously any pathological manifestations of the jugular vein.

Causes

It should be noted that phlebectasia does not depend on the age of the patient; it can equally occur in both an adult and a child.

Causes of dilatation of the jugular vein:

• neck injuries, traumatic brain injuries, head and cervical contusions, concussions;
• spinal and back injuries, rib fractures leading to general venous stagnation;
• long forced, uncomfortable posture, sedentary work without a break;
• vascular diseases, heart failure, heart defects, coronary and hypertension;
• benign and malignant tumors of internal organs, blood cancer;
• diseases of the spine and back muscles, in which the patient takes a forced position to alleviate the condition, for example, osteochondrosis;
• endocrine diseases.

Often, with the development of dilatation of the jugular vein, there are several factors that cause the disease.

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Carrying out diagnostics

To identify and make a final diagnosis, a specialist will need the results of several laboratory and instrumental studies:

• duplex scanning of cervical vessels;
• duplex transcranial scanning;
• multislice computed tomography (MS CT) of the cervical and thoracic regions;
• magnetic resonance imaging using contrast agents;
• computed tomography of the skull;
• ultrasound examination of the neck and chest;
• phlebography;
• diagnostic puncture;
• general blood analysis.

These are the main diagnostic methods that are used to make a final diagnosis. At the same time, the doctor can prescribe only some of them to obtain a complete information picture of the disease.

However, to identify the exact causes of the disease, it may be necessary to consult specialists who will help determine the main factor in the occurrence of jugular vein phlebectasis. Such specialists include a neurologist, endocrinologist, and oncologist.

Symptoms of the disease

Like any other varicose veins, phlebectasia of the jugular vein initially occurs without any obvious symptoms. If the exposure factor is insignificant, then the disease can develop for years without leaving any traces on the body.

The first signs are a visual enlargement of the vessel in the neck, with the upper vessels forming a kind of blue sac, and the lower ones - a clear swelling resembling a spindle in shape. In this case, there is no obvious discomfort for the patient, there is no pain or other subjective signs of the disease.

In the future, a feeling of pressure may develop at the site of the expansion of the jugular vein, especially when bending, screaming or sudden movements of the head.

In advanced cases, painful sensations appear in the neck, the voice becomes hoarse, and difficulty breathing may occur.

The last two cases require immediate treatment, since the development of such symptoms negatively affects the general condition of the body.

Treatment methods

After making a diagnosis and recognizing that the jugular vein is dilated, it is time to decide on treatment procedures.

Treatment primarily depends on the degree of the disease, how much the vessel is dilated and its effect on the surrounding tissues and the general condition of the body. If there is no reason to fear for the normal physiological state of the patient, then active treatment is not undertaken. The work of specialists comes down to monitoring the condition of the vein, the dynamics of its expansion and the impact on surrounding organs and tissues.

Complications and their prevention

Complications from such conditions are rare. Basically, this is the threat of rupture of the affected and weakened section of the vein and subsequent heavy bleeding. This condition is fatal in most cases.

To prevent this scenario, jugular vein enlargement should be treated whenever possible. If the doctor suggests or even insists on early surgical intervention, it should be performed.

Preventive measures

The main preventive measures can be called:

• avoiding stress on the body in general and on the neck in particular if there is a predisposition or initial signs of dilation of the jugular vein;
• timely cure for diseases that cause varicose veins;
• regular scheduled examinations for early detection of the disease;
• healthy lifestyle, moderate physical activity, proper nutrition.

The main emphasis should be on people who are predisposed to dilation of the jugular vein due to hereditary characteristics.

It must be remembered that vein diseases are difficult to prevent, but you can easily stop and get rid of them in the initial stages of development. That's why regular checkups with your doctor will help you avoid problems in the future.

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