Chronic cerebrospinal venous insufficiency and venous stenoses in multiple sclerosis

Acta Neurologica Scandinavica, 05/02/2012

The results do not corroborate the presence of vascular pathology in relapsing–remitting multiple sclerosis (MS) (RRMS) and the authors found no evidence supporting the chronic cerebrospinal venous insufficiency (CCSVI) hypothesis.

Methods

  • The authors investigated cervical and cerebral veins in 24 patients with relapsing-remitting MS (RRMS) and 15 healthy controls, using extracranial high-resolution ultrasound colour Doppler (US-CD) and transcranial colour Doppler sonography (TCDS), as well as magnetic resonance imaging (MRI) and phase-contrast MR blood flow measurements (PC-MR) of the cervical veins.

Results

  • US-CD could not identify the left internal jugular vein (IJV) in one MS patient, other ultrasound examinations were normal in patients with MS.
  • There was no difference in mean cross-sectional area of the IJV in MS patients compared with controls.
  • Only one patient with MS and two healthy controls fulfilled one CCSVI criterion, and none fulfilled more than one CCSVI criterion.
  • MR venography showed insignificant IJV stenosis (1-49%) in two patients with MS, whereas 50-69% IJV stenosis was detected in two healthy controls.
  • There was no difference in PC-MR measurements of mean IJV blood flow between patients with MS and controls.

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