From Gray's Anatomy--
At the root of the neck the right internal jugular vein is placed at a little distance from the common carotid artery, and crosses the first part of the subclavian artery, while the left internal jugular vein usually overlaps the common carotid artery. The left vein is generally smaller than the right, and each contains a pair of valves, which are placed about 2.5 cm. above the termination of the vessel.
Doctors typically do procedures on the right side (measure venous pulse, place catheters, endovascular procedures), since it is usually larger, but there are variants.
We studied 14 females and 11 males with an average age of 46 ± 12.9 years and average heights and weights of 168.1 ± 10.5 cm and 81.1 ± 16.1 kg. Indications for surgery included tumor, aneurysm and arteriovenous malformation. The right internal jugular vein was larger than the left in 19 patients (76.0%), the 2 veins were equal in size in 2 patients (8.0%) while the left was larger in 4 patients (16.0%). Overall, the average diameter of the right internal jugular vein was larger than the left, 1.48 ± 0.39 cm vs 1.12 ± 0.36 cm (p = .001). On angiography, the right jugular bulb was dominant in 11 patients (44.0%), jugular bulb drainage was deemed equal in 10 patients (40%) and the left jugular bulb was dominant in 4 patients (16%). In comparing ultrasound to angiography, the 4 patients with larger veins on the left had left dominant cerebral drainage while the 2 patients with equal veins had equal cerebral drainage. Of the 19 patients whose right internal jugular veins were larger, 11 patients had a right dominant jugular bulb while the remaining 8 patients had equal drainage (table 1). In the 15 patients who had a dominant jugular bulb, ultrasound predicted the dominant side with 100% sensitivity and specificity.
Thanks for Dr. Simka's information on this, Erika. Seems to be a pattern for many, not all.
Jeff's presenting issues of his first MS flare were on his left side. His left jugular was a thread and his right was also 80% closed when Dr. Dake saw him. The right is now open (like CureIous) and because of the difference, he has tinnitus (a whoosing sound when lying down) and can get postural headaches. We are waiting for further evaluation, because there may be nothing left to do for that left side--short of vein surgery. The vein is scrawny and defers to a larger collateral. BUT he is much better with one good side. He sleeps deeply, dreams again, no urgent bladder, no MS fatigue, he's active and involved in life and work again. He says this has all been worth it, because he is able to enjoy living again...and that was not the case prior to angio.
So glad to hear you're better than during pregnancy, Gibbs...we were all worried. Babies are the best. Now that my kid is six feet tall and shaving, I look back on those days fondly. Precious time.
Bluesky--you're right, we are getting there.