No Cerebral or Cervical Venous Insufficiency in US Veterans With Multiple Sclerosis.
Marder, Ellen MD; Gupta, Pramod MD; Greenberg, Benjamin M. MD; Frohman, Elliot M. MD, PhD; Awad, Amer M. MD; Bagert, Bridget MD; Stuve, Olaf MD, PhD
[Article]
Archives of Neurology.
68(12):1521-1525, December 2011.
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Objective: To determine if chronic cerebral venous insufficiency exists in patients with multiple sclerosis (MS) using ultrasonography and 4-dimensional color Doppler ultrasonography examination and unverified criteria proposed by Zamboni et al.
Design: Patients with MS and clinically isolated syndrome were matched by age and sex with subjects with migraine or no neurological disease. All subjects underwent gray-scale, color, and spectral Doppler ultrasonography examination of the internal jugular veins (IJVs), vertebral veins, and deep cerebral veins for stenosis, absence of signal, and reflux.
Setting: Academic MS center.
Patients: All patients with MS fulfilled revised McDonald criteria for the diagnosis of MS. Patients with clinically isolated syndrome exhibited a typical transient focal neurological deficit and had magnetic resonance imaging lesions typical of MS. Control subjects were recruited from the VA migraine clinic or staff.
Main Outcome Measures: Five parameters of venous outflow used by Zamboni et al were examined: (1) IJV or vertebral vein reflux, (2) deep cerebral vein reflux, (3) IJV stenosis, (4) absence of flow in IJVs or vertebral veins, and (5) change in cross-sectional area of the IJV with postural change.
Results: There was no significant difference in the number and type of venous outflow abnormalities in patients with MS compared with controls.
Conclusion: This study does not support the theory that chronic cerebral venous insufficiency exists in MS.
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