Internal Jugular Vein Thrombosis Clinical Presentation

Updated: Mar 08, 2022
  • Author: Dale K Mueller, MD; Chief Editor: Vincent Lopez Rowe, MD, FACS  more...
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History and Physical Examination

The symptoms and signs of internal jugular (IJ) vein thrombosis are often very subtle, making it easy to overlook the diagnosis. Pain and swelling at the angle of the jaw and a palpable cord beneath the sternocleidomastoid both may be absent in a minority of patients. Once infection has set in, other objective findings may be found. The following clinical manifestations have been described [4] :

  • Fever (83%)
  • Leukocytosis (78%)
  • Mass or neck swelling (72%)
  • Cervical pain (66%)
  • Cord sign (39%)
  • Pleuropulmonary complications (28%)
  • Jugular foramen syndrome (6%)
  • Increased intracranial pressure with symptoms that include headache, visual disturbances, and altered sensorium (rare) [5]


Once the diagnosis is made, vigilance should be maintained for the following complications:

Infected thrombophlebitis has the following complications:

  • Systemic sepsis syndrome
  • Septic emboli to lungs, liver, spleen, brain, skin, muscle, and bone marrow
  • Empyema
  • Renal failure
  • Hepatic dysfunction
  • Cerebral edema