Dincă Viviana, Ionescu Paris, Tudose Răzvan Costin, Munteanu Mădălin, Vrapciu Alexandra Diana, Rusu Mugurel Constantin
Division of Anatomy, Department 1, Faculty of Dentistry, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Department of Obstetrics and Gynaecology, Ovidius University, 900527 Constanţa, Romania.
Medicina (Kaunas). 2025 Sep 8;61(9):1627. doi: 10.3390/medicina61091627.
The internal jugular vein (IJV) is of utmost importance during various surgical and endovascular approaches, including central access. It descends through the parapharyngeal space, carotid triangle, and sternocleidomastoid region. The anatomical variables of the IJV are mainly related to its calibre and dominance, number of venous channels (i.e., duplications and fenestrations), and compression sites. Specific compressions of the IJV are not exclusively due to the jugular nutcracker between the styloid process (SP) of the temporal bone and the C1 transverse process, which, in turn, should not be granted the eponym of Eagle. The possible morphologies of the SP and ossified stylohyoid chain are discussed here. Additionally, the digastric and sternocleidomastoid muscles, the hyoid, and the distorted carotid arteries may compress the IJV, thereby raising intracranial pressure. Here, a case is documented with a long inferior petrosal sinus adjacent to the IJV, both compressed into the C1-styloid nutcracker, which is an absolute novelty. Multiple compression sites of the IJV are supported here with original evidence. All anatomical variables of the IJV are relevant, as they may lead to stenoses or interfere with IJV cannulation. In rare cases of IJV agenesis, multiple compression sites on the opposite side may significantly alter bilateral cerebral drainage. Different methods may be used to decompress a stenotic IJV, including styloidectomy. In conclusion, the anatomical variables of the IJV should be acknowledged by practitioners and documented on a case-by-case basis.
颈内静脉（IJV）在包括中心静脉通路在内的各种外科手术和血管内手术入路中至关重要。它下行穿过咽旁间隙、颈动脉三角和胸锁乳突肌区域。颈内静脉的解剖学变量主要涉及其管径和优势、静脉通道数量（即重复和开窗）以及受压部位。颈内静脉的特定压迫并非仅由颞骨茎突（SP）与C1横突之间的“颈静脉夹”所致，反过来，也不应将其命名为伊格尔（Eagle）。本文讨论了茎突和骨化茎突舌骨链的可能形态。此外，二腹肌和胸锁乳突肌、舌骨以及扭曲的颈动脉可能会压迫颈内静脉，从而升高颅内压。在此记录了一例与颈内静脉相邻的下岩窦较长，二者均被压入C1 - 茎突夹的病例，这是一个绝对的新发现。本文提供了颈内静脉多个受压部位的原始证据。颈内静脉的所有解剖学变量都很重要，因为它们可能导致狭窄或干扰颈内静脉插管。在罕见的颈内静脉缺如病例中，对侧的多个受压部位可能会显著改变双侧脑引流。可采用不同方法对狭窄的颈内静脉进行减压，包括茎突切除术。总之，从业者应认识到颈内静脉的解剖学变量，并逐例记录。
