Chronic cerebrospinal venous insufficiency and venous stenoses in multiple sclerosis Acta Neurologica Scandinavica, 05/02/2012

Blinkenberg M et al. – 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.

• 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.

• 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.