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The related main theme: A. Stroke and Cerebral vascular disorders

有症狀頸內靜脈血栓的早期發現和再通的罕見病例:病例報告。

A Rare Case of Early Detection and Recanalization of Symptomatic Internal Jugular Vein Thrombosis: A case report

Authers:

劉懿, MD 1 , 丁吉新, MD 2 , 王志偉, MD 1 , 李俊泰, MD 1 , 楊富吉, PhD, MD 1 , 
Yi  Liu, MD 1 , Hsin Chi Ting, MD 2 , Wei  Chih Wang, MD 1 , Tay  Jiunn Lee, MD 1 , Chi Fu Yang, PhD, MD 1 , 
1 三軍總醫院
2 台中國軍醫院
1 Tri-service general hospital
2 Taichung Armed Forces General Hospital,
Corresponding Author:

劉懿
Yi  Liu , MD
三軍總醫院
Tri-service general hospital

keywords: Internal Jugular Vein Thrombosis, Recanalization
Abstract for case report

CASE REPORT:
A 42-year-old presented with a progressively worsening headache for 7 days. There were no remarkable findings in physical examinations and laboratory studies. A thrombosis with critical stenosis in her left internal jugular vein(IJV) was diagnosed using color-coded Duplex ultrasonography and confirmed with magnetic resonance venography. She was treated with subcutaneous low-molecular-weight heparin followed by warfarin. Seven days later, the patient showed remarkable clinical improvement. Recanalization of the previously highly stenosed IJV was seen in the follow-up CCDU. After years follow up, there was no recurrent of deep vein thrombosis and there were no residual neurologic sequelae.

DISCUSSION:
Isolated IJVT is rare, the main cause was foreign bodies like central venous catheters and pacemakers, then followed by malignance, infection, coagulation abnormalities, ovarian hyperstimulation syndrome, autoimmune disorders, etc. With a similar management as for deep vein thrombosis of the leg, anticoagulant is the most common treatment, consisting of low molecular weight heparin and vitamin K antagonists. Also, thrombolysis, surgery, thrombectomy and balloon dilatation were more invasive options. The main complication of IJVT was pulmonary embolism, the following were mortality from underlying malignancy and non-major hemorrhagic manifestations related to anticoagulant therapy. In our case, we highlight the timely detection of IJVT via noninvasive manner and early recanalization of occluded vessels without complications. It’s important to differential the causes from malignancy, infection, inflammation, autoimmune, structural or coagulation abnormalities to ovarian hyperstimulation syndrome, particularly in women.


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