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The Vagus Nerve (Cranial Nerve X)

The Vagus Nerve in the Cervical Region (supine with head turned towards the opposite side)

The cervical vagus nerve is about 2 mm in diameter and “honeycomb” in sonographic appearance. The vagus nerve is often triangle shaped as it is wedged between the internal jugular vein and carotid artery in the lower neck (Video 1 MB).

 
 
   
 

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The vagus nerve lies in the posterior angle formed between the internal jugular vein and the carotid artery (Giovagnorio and Martinoli, 2001). Location of the vagus nerve in the anterior angle is rare (0.7% of healthy subjects, Giovagnorio and Martinoli, 2001). In some subjects the vagus nerve will cross in front of the carotid artery (Video 612 KB).

References

Giovagnorio F, Martinoli C. Sonography of the cervical vagus nerve: normal appearance and abnormal findings. AJR Am J Roentgenol. 2001 Mar;176(3):745-9. PMID: 11222217

Knappertz VA, Tegeler CH, Hardin SJ, McKinney WM. Vagus nerve imaging with ultrasound: anatomic and in vivo validation. Otolaryngol Head Neck Surg. 1998 Jan;118(1):82-5. PMID: 9450833

Solbiati L, De Pra L, Ierace T, Bellotti E, Derchi LE. High-resolution sonography of the recurrent laryngeal nerve: anatomic and pathologic considerations. AJR Am J Roentgenol. 1985 Nov;145(5):989-93. PMID: 3901711

Silvestri E, Martinoli C, Derchi LE, Bertolotto M, Chiaramondia M, Rosenberg I. Echotexture of peripheral nerves: correlation between US and histologic findings and criteria to differentiate tendons. Radiology. 1995 Oct;197(1):291-6. PMID: 7568840