title: [Incompetence of internal jugular vein valve in patients with transient global amnesia].
abstract: OBJECTIVE
  Transient global amnesia (TGA) could be related to acute ischemic disturbances in mesial parts of temporal lobes, which are important for memory. Incompetence of internal jugular vein (IJV) valve with venous congestion causes venous microthrombosis of hippocampus. The aim of this study was to investigate the frequency of IJV valve incompetence, as well as other hemodynamic and structural properties of cerebral circulation in TGA patients.
  
  
  METHODS
  IJV valve competence was investigated in 40 TGA patients and 30 persons of the control group (matched by age and sex), as well as detection of microembolic signals and detection of right to left cardiopulmonal shunt, cerebral vasomotor reactivity and echocardiography by color triplex ultrasonography and transcranial doppler.
  
  
  RESULTS
  A significant difference in frequency of IJV valve incompetence was found between the TGA patients and the control persons (55% TGA vs. 30% controls; p < 0.001). We did not find a significant structural (plaques frequency) or hemodynamic (flow velocity, pulsatility index) differences on arteries of the neck and cerebral arteries between the TGA patients and the controls, except for the increased pulsatility index on the basilar artery (40% TGA vs. 16.6% controls; p < 0.01) and decreased vasomotor reactivity in TGA patients (50% TGA vs 26.6% controls;p < 0.001). Microembolic signals were detected very rarely (17.5% TGA patients vs. 13.3% controls; p > 0.05), as well as right to left cardiopulmonal shunt (15% TGA vs. 16.6% controls; p > 0.05), indicating that embolism was not important for pathogenesis of TGA. Transesophageal echocardiography confirmed it, because only one TGA patient had a potent foramen ovale.
  
  
  CONCLUSIONS
  We found a significantly increased frequency of IJV incompetence in the TGA patients, which confirmed the role of vein drainage disturbances in pathogenesis of TGA.
authors.affiliation: Klinicki centar Srbije, Institut za neurologiju, Beograd, Srbija. zagajovanovic@sezampro.rs
authors.forename: Zagorka B
authors.initials: ZB
authors.lastname: Jovanović
authors.forename: Bosiljka Vujisić
authors.initials: BV
authors.lastname: Tesić
authors.forename: Aleksandra M
authors.initials: AM
authors.lastname: Pavlović
authors.forename: Jasna J Zidverc
authors.initials: JJ
authors.lastname: Trajković
authors.forename: Milija D
authors.initials: MD
authors.lastname: Mijajlović
authors.forename: Marija V Boririć
authors.initials: MV
authors.lastname: Kostić
authors.forename: Edita Z
authors.initials: EZ
authors.lastname: Cvitan
authors.forename: Aleksandra P
authors.initials: AP
authors.lastname: Radojicić
authors.forename: Gordana
authors.initials: G
authors.lastname: Tomić
authors.forename: Ana
authors.initials: A
authors.lastname: Sundić
authors.forename: Nadezda M Sternić
authors.initials: NM
authors.lastname: Covicković
mesh_terms: D020236:Amnesia, Transient Global / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014463:Ultrasonography