Internal Jugular Vein Valve Morphology in the Patients with Chronic Cerebrospinal Venous Insufficiency (CCSVI); Angiographic Findings and Schematic Demonstrations

Al-Omari, Mamoon; Al-Bashir, Areen K.

doi:10.2174/157488712800100297

Cited by 19 publications

(19 citation statements)

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“…Evidence suggests that CCSVI is primarily due to the presence of abnormal jugular valves [5, 8–10]. However, compression of the veins draining the central nervous system by a muscle can be the other, nonvalvular cause of compromised cerebral venous outflow.…”

Section: Introductionmentioning

confidence: 99%

Internal Jugular Vein Entrapment in a Multiple Sclerosis Patient

Simka

Majewski

Fortuna

et al. 2012

Case Reports in Surgery

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We describe a multiple sclerosis patient presenting with compression of the internal jugular vein caused by aberrant omohyoid muscle. Previously this patient underwent balloon angioplasty of the same internal jugular vein. Ten months after this endovascular procedure, Doppler sonography revealed totally collapsed middle part of the treated vein with no outflow detected. Still, the vein widened and the flow was restored when the patient's mouth opened. Thus, the abnormality was likely to be caused by muscular compression. Surgical exploration confirmed that an atypical omohyoid muscle was squeezing the vein. Consequently, pathological muscle was transected. Sonographic control three weeks after surgical procedure revealed a decompressed vein with fully restored venous outflow. Although such a muscular compression can be successfully managed surgically, future research has to establish its clinical relevance.

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Section: Introductionmentioning

confidence: 99%

Internal Jugular Vein Entrapment in a Multiple Sclerosis Patient

Simka

Majewski

Fortuna

et al. 2012

Case Reports in Surgery

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“…IVUS has revealed even more lesions than catheter venography, since CCSVI seems to be principally an endoluminal disease. 21,[28][29][30][31] This is probably the reason why investigators who utilized nondiluted contrast found less frequent (55%-70%) pathology in patients with multiple sclerosis. 32,33 Also, it should be remembered that catheter venography is inadequate to demonstrate external compression of the IJVs by aberrant muscles, because radiologic contrast injected into the vein, even under low pressure, can easily reopen a compressed vein.…”

Section: Results Of Catheter Venography and Ivusmentioning

confidence: 99%

“…30,[42][43][44] Further, current magnetic resonance imaging is not very good at demonstrating pathology of the jugular valves (catheter venography studies tell us that this is the most common CCSVI abnormality). 25,[27][28][29]45 These valves are tiny structures, which are not easily visible on standard magnetic resonance images. Also, artifacts resulting from respiratory and cardiac movements routinely blur the area of the jugular valves, as does gadolinium contrast.…”

Section: Figurementioning

confidence: 99%

“…57,114 Still, the pathology that is most often seen is a stenotic "over-competent" jugular valve. 25,[27][28][29]45,57,66,77 Such a pathological valve has been found in 70%-90% of patients with multiple sclerosis and also in many healthy controls. 33,35 Considering these many faces of CCSVI, it becomes more comprehensible why the results of prevalence studies have been so discordant.…”

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confidence: 99%

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Chronic cerebrospinal venous insufficiency: current perspectives

Simka¹

2014

JVD

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“…Although the reference test for the detection of IJV abnormalities (catheter angiography) is widely regarded as the golden standard for the assessment of vascular pathologies, in the territory of jugular veins it is actually a 'tarnished' standard [19,20]. In CCSVI patients the most prevalent abnormality is the stenotic, 'over-competent' jugular valve [21]. Using invasive diagnostics (catheter venography) about 90% of MS patients can demonstrate such venous occlusive lesions [9,10,[14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of Doppler sonography and magnetic resonance venography for the assessmentv of impaired outflow from the internal jugular vein in patients with multiple sclerosis

Hartel¹,

Kluczewska²,

Simka³

2015

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Objectives: This prospective study was aimed at evaluation of diagnostic value of Doppler sonography and magnetic resonance (MR) venography in the internal jugular vein territory. Material and methods: There were assessed 126 patients (252 internal jugular veins). The patients were initially diagnosed using Doppler sonography and MR venography, and then catheter venography of the veins was performed. For the purpose of this study catheter venography was regarded the reference test. We interpreted sonographic findings in the context of criteria proposed by Zamboni and criteria by International Society for Neurovascular Disease (ISNVD). We applied MR protocols aimed at flow assessment in the scanned veins: fast spin echo-T2-weighted sequences with fat saturation, and axial two-dimensional time-of-flight imaging with saturation band positioned below planned slices. Results: Catheter venography revealed lesions in 171 (67.9%) of the veins studied, primarily stenotic jugular valves (88.0% of abnormal veins). We found that sonographic criteria, using either Zamboni or ISNVD criteria were of poor diagnostic accuracy (Cohen's k coefficient < 0.1). MR venography with the use of our dedicated protocols appeared to be a slightly better diagnostic tool (k about 0.4). Conclusions:The results of our MR imaging protocols for the assessment of abnormalities in internal jugular veins were better if compared to Doppler sonography. Yet, even MR venography was far from being perfect and at the moment neither this examination nor Doppler sonography cannot replace invasive catheter venography and should not be used as a definitive test for diagnosing anatomical and functional abnormalities in the internal jugular veins.

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Internal Jugular Vein Valve Morphology in the Patients with Chronic Cerebrospinal Venous Insufficiency (CCSVI); Angiographic Findings and Schematic Demonstrations

Cited by 19 publications

References 0 publications

Internal Jugular Vein Entrapment in a Multiple Sclerosis Patient

Internal Jugular Vein Entrapment in a Multiple Sclerosis Patient

Chronic cerebrospinal venous insufficiency: current perspectives

Diagnostic accuracy of Doppler sonography and magnetic resonance venography for the assessmentv of impaired outflow from the internal jugular vein in patients with multiple sclerosis

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