Horner Syndrome Caused by Central Venous Port Placement via the Internal Jugular Vein: A Case Report

Figures

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  Fig. 1.. A chest radiograph taken immediately after central venous port placement. No pneumothorax is observed. Puncture point for the internal jugular vein is between C6 and C7 levels of the cervical spine. No catheter kink is seen.

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  Fig. 2.. Axial computed tomography images with contrast enhancement taken three months after the procedure. Neither a procedure related abnormality nor any metastatic lesion that may cause Horner syndrome is observed around the internal jugular vein (black arrowhead) and the catheter. The black arrow indicates the longus colli muscle, and the white arrow indicates the anterior scalene muscle.

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  Fig. 3.. A schematic illustration of the anatomical structures in axial image (from the view of the operator standing on the cranial side of the patient) at C6 level of the cervical spine. CA, the right common carotid artery; IJV, the right internal jugular vein; VA, the right vertebral artery; LCM, the right longus colli muscle; ASM, the right anterior scalene muscle; 1, the right cervical sympathetic nerve trunk; 2, the right vagus nerve; 3, the right phrenic nerve; 4, the right brachial plexus. (This figure was constructed using an article by Akashi et al. [22].)

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  Fig. 4.. A schematic illustration of the puncture tract (shown as a large black arrow) for the right internal jugular vein, with 45-degree neck rotation to the left (the same anatomical schema as seen in Fig. 3) . If vertical puncture from anterior to posterior is performed on axial (short-axis) view, the cervical sympathetic nerve and longus colli muscle are located in the path of the puncture tract. IJV, the right internal jugular vein; LCM, the right longus colli muscle; 1, the right cervical sympathetic nerve trunk.