The internal jugular vein is the primary venous drainage of the brain and face, formed by the sigmoid sinus exiting the skull through the jugular foramen. With the carotid artery and vagus nerve it forms the carotid sheath contents. The IJV is the most common site for central venous catheterisation because of its size, accessibility, and relatively low risk of pneumothorax compared to the subclavian approach.
| Origin | Continuation of the sigmoid sinus through the jugular foramen at the base of the skull |
|---|---|
| Course | Descends in the carotid sheath alongside the common carotid artery and vagus nerve, joining the subclavian vein to form the brachiocephalic vein behind the sternoclavicular joint |
| Branches |
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IJV central line insertion complications include carotid artery puncture (compressible with manual pressure), pneumothorax (less common than subclavian), air embolism, and thoracic duct injury on the left side. Ultrasound-guided IJV cannulation has significantly reduced complication rates and is now the standard of care. Jugular venous pressure examination provides non-invasive assessment of right heart filling pressure and is elevated in right heart failure, cardiac tamponade, and superior vena cava obstruction.
IJV catheterisation complications including carotid puncture, pneumothorax, and line-related bloodstream infection, reduced by ultrasound guidance and strict aseptic technique.
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