Unusual origin and potentially hazardous course of the major blood vessels in neck – A clinically relevant rare case

Left brachiocephalic vein begins from junction of left subclavian and left internal jugular vein posterior to medial end of left clavicle. It crosses to the right moving slightly in inferior direction and joins with right brachiocephalic vein to form superior vena cava. During its oblique course it crosses the left subclavian artery, left common carotid artery and brachiocephalic trunk in the superior mediastinum. Brachiocephalic trunk is described as the largest branch of the arch of the aorta, 4 to 5 cm in length, and arises from the arch’s convexity, posterior to the center of the manubrium sterni. It ascends posterolaterally to the right, at first anterior to trachea, then on its right. At the level of right sternoclavicular joint’s upper border it divides into right common carotid and right subclavian arteries [1]. At the lower part of neck the two common carotid arteries are separated from each other by a very narrow interval, which contains the trachea (Figure 1).