Venous variations in neck region: cephalic vein

The cephalic vein, defined as the vein originating in the radial end of the dorsal venous arch, crosses superficial to the anatomical snuffbox and travels upward along the anterior border of the brachioradialis muscle in the forearm [1,2]. It ascends lateral to biceps and between pectoralis major and deltoid muscles, and passes through the infraclavicular fossa, and drains into the axillary vein. It may communicate with the external jugular vein via a branch positioned anterior to the clavicle before emptying into the axillary vein [1,3]. Most commonly central venous access is achieved at the bedside through the subclavian, femoral, brachiocephalic and cephalic veins [4]. The cephalic vein is suitable for central venous access, pacemaker and defibrillator implantation, and reported to have a lower incidence of complications than subclavian puncture [5]. Hence, the cephalic vein is clinically important. The correct anatomical knowledge of the cephalic vein is of critical importance when considering emergency procedures [6]. Many authors have reported the anatomical variations of the cephalic vein: absent or very thin, accessory cephalic vein, different course, and various terminations [6–10]. We found a variation of the cephalic vein and the structures nearby during routine dissection. In this case we described a variation of the cephalic vein, which was joined the external jugular vein. Deog-Im KIM Seung-Ho HAN