Cerebral Venous Outflow Resistance and Interpretation of Cervical Plethysmography Data With Respect to the Diagnosis of Chronic Cerebrospinal Venous Insufficiency

Phlebology. 2014 Apr;29(3):191-99. doi: 10.1258/phleb.2012.012039. Epub 2013 May 6.


Objective: While chronic cerebrospinal venous insufficiency (CCSVI) can be characterized using cervical plethysmography, much remains unknown about the haemodynamics associated with this procedure. The aim of the study was therefore to gain a deeper understanding of the observed haemodynamics.

Method: Forty healthy controls and 44 CCSVI patients underwent cervical plethysmography, which involved placing a strain-gauge collar around their necks and tipping them from the upright (90(o)) to supine position (0(o)) in a chair. Once stabilized, they were returned to the upright position, allowing blood to drain from the neck. A mathematical model was used to calculate the hydraulic resistance of the extracranial venous system for each subject in the study.

Results: The mean hydraulic resistance of the extracranial venous system was 10.28 (standard deviation [SD] 5.14) mmHg.s/mL in the healthy controls and 16.81 (SD 9.22) in the CCSVI patients (P < 0.001).

Conclusions: The haemodynamics of the extracranial venous system are greatly altered in CCSVI patients.

Keywords: cerebral venous system; chronic cerebrospinal venous insufficiency; multiple sclerosis; plethysmography; venous haemodynamics.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Cerebrovascular Circulation*
  • Chronic Disease
  • Female
  • Hemodynamics
  • Humans
  • Male
  • Middle Aged
  • Models, Cardiovascular*
  • Plethysmography / methods
  • Venous Insufficiency* / pathology
  • Venous Insufficiency* / physiopathology