No cerebral or cervical venous insufficiency in US veterans with multiple sclerosis

Arch Neurol. 2011 Dec;68(12):1521-5. doi: 10.1001/archneurol.2011.185. Epub 2011 Aug 8.


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.

Publication types

  • Comparative Study

MeSH terms

  • Cerebral Veins / diagnostic imaging*
  • Chronic Disease
  • Female
  • Humans
  • Jugular Veins / diagnostic imaging*
  • Male
  • Middle Aged
  • Migraine Disorders / diagnosis
  • Multiple Sclerosis / diagnosis*
  • Ultrasonography, Doppler
  • United States
  • Venous Insufficiency / classification*
  • Venous Insufficiency / diagnosis*
  • Veterans