Discussion:
Embryological developmental abnormalities cause vascular malformations.
Hemangiomas fade away over time. However, vascular abnormalities can
grow and last a lifetime. Even though vascular abnormalities are present
at birth, they might not have been discovered until adolescence or the
elderly (5). Venous abnormalities are generally asymptomatic and
typically occur in the head and neck region (6).
Congenital agenesis of the IJV is a very unusual occurrence (3). The CT
imaging of an instance of IJV agenesis is described in this article.
Early detection can help limit damages during medical therapy of
neurological conditions, including headaches, and avoid misdiagnosis and
other prevalent diagnoses. The IJVs are the prominent venous outflow
veins in the brain. In a patient with congenital agenesis of the IJV,
impairment of the alternate pathways of vascular supply from the cranial
cavity can have catastrophic repercussions. Embryological developmental
abnormalities cause vascular anomalies in the head and neck region,
which can persist asymptomatically (7).
IJV passes through the neck’s carotid sheath and behind the clavicle’s
sternal end. It then joins the subclavian vein to form the
brachiocephalic vein, which travels through the thorax to reach the
superior vena cava. Clinically, knowledge of IJV anatomical differences
is critical for venous applications. Central catheters are often used in
intensive care units. IJV anomalies may prevent the practitioner from
performing the procedure, causing significant consequences. To avoid
difficulties, the surgeon should conversate with the anatomy and
variations of IJV (3).
Different IJV anomalies have been revealed in the scientific literature:
partial or total duplication (8, 9), stenosis, complete occlusion,
distortions, and intraluminal structures, such as membranes, webs, and
inverted valves (10). These are frequently discovered by chance or
during neck diagnostic techniques due to a suspicious tumour and are
sometimes the consequence of compensatory contralateral IJV enlargement
(3). Our case was slightly different because he identified IJV agenesis
based on the headache evaluation. Our patient had no prior history of
any other illnesses or thrombosis history. There was no thrombosis on
ultrasonography, CT, or neuroimaging, and the IJV was congenitally
agenesis.
Patients who report to the emergency department frequently complain of
headaches. Most of these headaches are harmless, but others have a more
organic severe cause. Patients may present with a chronic headache issue
that they cannot manage. The history of headache diagnosis is thoroughly
addressed, followed by a discussion of headache patients’ emergency
presentations. Subarachnoid haemorrhage, meningitis, sinusitis,
glaucoma, internal carotid artery dissection, and cerebrovascular
illness are the causes for worry and a full explanation of the
differential diagnosis. Analgesics, NSAIDs, opioids, and end ergotamine
formulations are among the drugs discussed for symptomatic headache
treatment. In the emergency service, strategies for treating frequent,
chronic headaches keep in mind that agenesis of the jugular venous
system can play a role—one of the uncommon causes of headaches that we
have seen in our instances. Limitations, more advanced intervention can
be used to rule out any linkage between internal jugular vein agenesis
and headaches, as well as surgical treatment for this result.