Spontaneous and nonspontaneous internal jugular vein thrombosis.

Nonspontaneous internal jugular vein thrombosis (IJVT) is an uncommon condition historically associated with deep neck infections during the pre-antibiotic era. Today, trauma to the internal jugular vein from catheterization and repeated intravenous injections by drug users are the leading causes of thrombosis, with direct extension of tumor being a rare cause. Spontaneous IJVT occurs when there are no apparent predisposing causes, although many of these patients may harbor an occult malignant neoplasm. Therefore, careful investigation and follow-up are imperative in these patients. The diagnosis of IJVT is readily confirmed by contrast-enhanced computed tomography or magnetic resonance imaging. Management of IJVT involves anticoagulation, antibiotics, and with few indications for surgical intervention.