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Unusual case of focal neck swelling: Phlebectasia of internal jugular vein with intracranial extension.

Malik V, Kumari A, Murthy T - Int J Appl Basic Med Res (2015 Jan-Apr)

Bottom Line: Owing to the rarity of this condition, a high index of suspicion is required to recognize the same and managed appropriately.We present a case of phlebectasia of the right IJV with intracranial extension and discuss its management.The case is being reported in view of its clinical rarity (the intracranial extension being extremely rare) and to highlight the available management strategies.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Military Hospital Gwalior, Morar Cantonment, Gwalior, Madhya Pradesh, India.

ABSTRACT
Internal jugular vein (IJV) phlebectasia is rare in occurrence and is frequently misdiagnosed and managed inappropriately. It commonly presents as a unilateral neck swelling which typically increases in size with valsalva maneuver. Although, the most common cause of a focal neck swelling, which increases in size with valsalva maneuver is laryngocele, the possibility of phlebectasia of IJV should always be borne in mind, especially in child. Owing to the rarity of this condition, a high index of suspicion is required to recognize the same and managed appropriately. We present a case of phlebectasia of the right IJV with intracranial extension and discuss its management. The case is being reported in view of its clinical rarity (the intracranial extension being extremely rare) and to highlight the available management strategies.

No MeSH data available.


Related in: MedlinePlus

Contrast-enhanced computed tomography (CECT) neck showed mildly dilated right Internal jugular vein (IJV) at rest, markedly increasing in size with valsalva maneuver. The focal fusiform swelling on valsalva measured 24 and 35 mm as max. Antero-posterior and transverse diameter respectively (a). The swelling extended from C4 vertebral body level to clavicle for cranio-caudal length of 7 cm (b). However, on performing valsalva maneuver, the entire right IJV (c), ipsilateral sigmoid and transverse sinus (d) were noted to be very prominent, compared to the normal left side. Screening CECT of brain revealed no additional abnormality
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Figure 2: Contrast-enhanced computed tomography (CECT) neck showed mildly dilated right Internal jugular vein (IJV) at rest, markedly increasing in size with valsalva maneuver. The focal fusiform swelling on valsalva measured 24 and 35 mm as max. Antero-posterior and transverse diameter respectively (a). The swelling extended from C4 vertebral body level to clavicle for cranio-caudal length of 7 cm (b). However, on performing valsalva maneuver, the entire right IJV (c), ipsilateral sigmoid and transverse sinus (d) were noted to be very prominent, compared to the normal left side. Screening CECT of brain revealed no additional abnormality

Mentions: Contrast-enhanced computed tomography (CECT) neck showed mildly dilated right IJV at rest, markedly increasing in size with valsalva maneuver. The focal fusiform swelling on valsalva measured 24 and 35 mm as max. AP and transverse diameter respectively [Figure 2a]. The swelling extended from C4 vertebral body level to clavicle for cranio-caudal length of 7 cm [Figure 2b]. However, on performing valsalva maneuver, the entire right IJV [Figure 2c], ipsilateral sigmoid and transverse sinus [Figure 2d] were noted to be very prominent, compared to the normal left side. Screening CECT of the brain revealed no additional abnormality.


Unusual case of focal neck swelling: Phlebectasia of internal jugular vein with intracranial extension.

Malik V, Kumari A, Murthy T - Int J Appl Basic Med Res (2015 Jan-Apr)

Contrast-enhanced computed tomography (CECT) neck showed mildly dilated right Internal jugular vein (IJV) at rest, markedly increasing in size with valsalva maneuver. The focal fusiform swelling on valsalva measured 24 and 35 mm as max. Antero-posterior and transverse diameter respectively (a). The swelling extended from C4 vertebral body level to clavicle for cranio-caudal length of 7 cm (b). However, on performing valsalva maneuver, the entire right IJV (c), ipsilateral sigmoid and transverse sinus (d) were noted to be very prominent, compared to the normal left side. Screening CECT of brain revealed no additional abnormality
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4318104&req=5

Figure 2: Contrast-enhanced computed tomography (CECT) neck showed mildly dilated right Internal jugular vein (IJV) at rest, markedly increasing in size with valsalva maneuver. The focal fusiform swelling on valsalva measured 24 and 35 mm as max. Antero-posterior and transverse diameter respectively (a). The swelling extended from C4 vertebral body level to clavicle for cranio-caudal length of 7 cm (b). However, on performing valsalva maneuver, the entire right IJV (c), ipsilateral sigmoid and transverse sinus (d) were noted to be very prominent, compared to the normal left side. Screening CECT of brain revealed no additional abnormality
Mentions: Contrast-enhanced computed tomography (CECT) neck showed mildly dilated right IJV at rest, markedly increasing in size with valsalva maneuver. The focal fusiform swelling on valsalva measured 24 and 35 mm as max. AP and transverse diameter respectively [Figure 2a]. The swelling extended from C4 vertebral body level to clavicle for cranio-caudal length of 7 cm [Figure 2b]. However, on performing valsalva maneuver, the entire right IJV [Figure 2c], ipsilateral sigmoid and transverse sinus [Figure 2d] were noted to be very prominent, compared to the normal left side. Screening CECT of the brain revealed no additional abnormality.

Bottom Line: Owing to the rarity of this condition, a high index of suspicion is required to recognize the same and managed appropriately.We present a case of phlebectasia of the right IJV with intracranial extension and discuss its management.The case is being reported in view of its clinical rarity (the intracranial extension being extremely rare) and to highlight the available management strategies.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Military Hospital Gwalior, Morar Cantonment, Gwalior, Madhya Pradesh, India.

ABSTRACT
Internal jugular vein (IJV) phlebectasia is rare in occurrence and is frequently misdiagnosed and managed inappropriately. It commonly presents as a unilateral neck swelling which typically increases in size with valsalva maneuver. Although, the most common cause of a focal neck swelling, which increases in size with valsalva maneuver is laryngocele, the possibility of phlebectasia of IJV should always be borne in mind, especially in child. Owing to the rarity of this condition, a high index of suspicion is required to recognize the same and managed appropriately. We present a case of phlebectasia of the right IJV with intracranial extension and discuss its management. The case is being reported in view of its clinical rarity (the intracranial extension being extremely rare) and to highlight the available management strategies.

No MeSH data available.


Related in: MedlinePlus