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Research ArticleBrainE

Mystery of Chronic Cerebrospinal Venous Insufficiency: Identical Venographic and Ultrasound Findings in Patients with MS and Controls

W. McAuliffe and A.G. Kermode
American Journal of Neuroradiology July 2013, 34 (7) 1370-1374; DOI: https://doi.org/10.3174/ajnr.A3390
W. McAuliffe
aFrom the Neurological Intervention and Imaging Service of Western Australia (NIIS) (W.M.)
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A.G. Kermode
bCentre for Neuromuscular and Neurological Disorders (A.G.K.), Australian Neuromuscular Research Institute, Sir Charles Gairdner Hospital, Nedlands, Perth, Australia.
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    Fig 1.

    Transverse sonographic images of the right IJV in supine (A) and sitting (B) positions demonstrating appropriate reduction in the CSA in a healthy 29-year-old woman with a supine CSA of 0.29 cm2, an abnormal Zamboni criterion,9 decreasing to 0.04 cm2 in the sitting position. Transverse sonographic images of the left IJV in supine (C) and sitting (D) positions demonstrating a mild paradoxical increase in the CSA from 0.81 to 1.03 cm2 in a 70-year-old man with secondary-progressive MS for 9 years (EDSS score, 7). No other criteria of Zamboni et al9 were present on ECD or TCD.

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    Fig 2.

    Selective anteroposterior venography of the right IJV demonstrates a high-grade narrowing of the distal IJV (black arrow) with an associated large collateral vein. This patient is a 44-year-old woman without MS who was being investigated for hyperparathyroidism. These appearances are remarkably similar to those in Zamboni et al (Fig 5)12; Zamboni et al (Fig 2Bg)9; and Simka et al (Fig 3)40.

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    Fig 3.

    Selective anteroposterior venography of the right IJV. A, A 60-year-old female patient without MS being investigated for hyperparathyroidism. B, A 51-year-old man without MS being investigated for Cushing disease with petrosal sinus sampling. Both images demonstrate very high-grade narrowing of the distal IJV. Figure 3A is remarkably similar to Fig 2 in Ludyga et al,45 and 3B is very similar to Fig 2B (e and f) from Zamboni et al,9 Fig 2 from Simka et al40 and Fig 4A from Zamboni et al.12

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    Fig 4.

    Anteroposterior venogram of the left IJV in a 50-year-old woman without MS being investigated for hyperparathyroidism. The moderate-sized collateral to the left brachycephalic vein is remarkably similar to that in Zamboni et al (Fig 4C).12

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American Journal of Neuroradiology: 34 (7)
American Journal of Neuroradiology
Vol. 34, Issue 7
1 Jul 2013
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Cite this article
W. McAuliffe, A.G. Kermode
Mystery of Chronic Cerebrospinal Venous Insufficiency: Identical Venographic and Ultrasound Findings in Patients with MS and Controls
American Journal of Neuroradiology Jul 2013, 34 (7) 1370-1374; DOI: 10.3174/ajnr.A3390

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Mystery of Chronic Cerebrospinal Venous Insufficiency: Identical Venographic and Ultrasound Findings in Patients with MS and Controls
W. McAuliffe, A.G. Kermode
American Journal of Neuroradiology Jul 2013, 34 (7) 1370-1374; DOI: 10.3174/ajnr.A3390
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