Because of the intimate association of the deep cervical lymph nodes with the internal jugular vein, this structure is usually sacrificed in a radical neck dissection. The writings of earlier authorities reflect hesitancy in doing this for fear of the resultant disturbances in circulation of the brain. It has become apparent, however, that such fears were largely without foundation, and the removal of one internal jugular vein, together with all of its tributaries, is now an inherent part of the operation.
Cerebral disturbances following removal of the jugular vein have been reported by some authors1,2,5-7,9 and denied by others.8,13 All agree that the chances of increased intracranial pressure are much greater when both internal jugular systems are ablated than when a single side is removed. Furthermore, the longer the interval of time between the removal of the two sides the less chance there appears to be of such