Suspected great auricular nerve injury following ultrasound-guided internal jugular vein catheterization: a case report

Abstract Background Peripheral nerve injury is a rare complication of central venous catheterization, and suspected injury to the great auricular nerve (GAN) after internal jugular vein (IJV) catheterization has not previously been reported. Case presentation A 50-year-old woman with recurrent uterine sarcoma developed pain and numbness over the ear lobule, mastoid region, angle of the mandible, and lateral neck after ultrasound-guided right IJV catheterization, predominantly involving the GAN territory. The catheter had been inserted cranial and lateral to the standard landmark to avoid an overlapping carotid artery, toward the region of Erb’s point, where the GAN courses superficially over the sternocleidomastoid muscle. Conclusions When vessel overlap necessitates a more cranial or lateral IJV puncture, the needle trajectory may approach the superficial course of the GAN. Clinicians should consider suspected GAN injury when a purely sensory deficit follows IJV catheterization in this distribution; in this patient, the disturbance showed near-complete recovery over approximately four months.