title: No cerebral or cervical venous insufficiency in US veterans with multiple sclerosis.
abstract: 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.
  
  
  METHODS
  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.
  
  
  METHODS
  Academic MS center.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  This study does not support the theory that chronic cerebral venous insufficiency exists in MS.
authors.affiliation: Neurology Section, VA North Texas Health Care System, Medical Service, Dallas VA Medical Center, 4500 South Lancaster Rd, Dallas, TX 75216, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Marder
authors.forename: Pramod
authors.initials: P
authors.lastname: Gupta
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Greenberg
authors.forename: Elliot M
authors.initials: EM
authors.lastname: Frohman
authors.forename: Amer M
authors.initials: AM
authors.lastname: Awad
authors.forename: Bridget
authors.initials: B
authors.lastname: Bagert
authors.forename: Olaf
authors.initials: O
authors.lastname: Stüve
mesh_terms: D002550:Cerebral Veins / Q000000981:diagnostic imaging*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis; D009103:Multiple Sclerosis / Q000175:diagnosis*; D018608:Ultrasonography, Doppler; D014481:United States; D014689:Venous Insufficiency / Q000145:classification* / Q000175:diagnosis*; D014728:Veterans