title: Chronic cerebrospinal venous insufficiency in multiple sclerosis: a sonographer-blinded case-control study.
abstract: OBJECTIVE
  To evaluate the presence of chronic cerebrospinal venous insufficiency (CCSVI) and cerebral venous anomalies in a consecutive series of patients with multiple sclerosis (MS), other neurologic diseases (NEU) and healthy controls (HC).
  
  
  METHODS
  A consecutive series of 80 MS patients, 41 HC and 26 NEU cases underwent a transcranial and extracranial echo-color Doppler (ECD) evaluation of cerebrospinal venous return in a sonographer-blinded fashion. According to the original Dr. Zamboni's protocol, CCSVI was diagnosed in presence of ≥2 ECD venous criteria.
  
  
  RESULTS
  We did not observe any association between CCSVI and MS. CCSVI was detected in 17.5% of MS cases, 7.3% of HC and 11.5% of NEU patients (p=0.333). The prevalence of internal jugular vein stenosis (IJV) and the proportion of patients with any positive ECD criterion differed significantly among groups, being higher in MS cases versus HC (67.5% and 76.2% versus 48.8% and 41.5%, respectively; p=0.005 and p=0.006). No relationship between CCSVI and MS type and severity was evidenced.
  
  
  CONCLUSIONS
  The present study argues against a positive link between CCSVI and MS risk or severity. Interestingly, a weak association between venous ECD anomalies (in particular IJV stenosis) and MS was observed in our population. This finding should be interpreted with caution due to the possible confounders and needs to be confirmed in large controlled studies.
authors: Neurology Unit, Maria Vittoria Hospital, Torino, Italy. daniele.imperiale@aslto2.piemonte.it
authors: Daniele
authors: D
authors: Imperiale
authors: Fabio
authors: F
authors: Melis
authors: Claudia
authors: C
authors: Giaccone
authors: Marilena
authors: M
authors: Guido
authors: Eva
authors: E
authors: Milano
authors: Carlo
authors: C
authors: Buffa
authors: Lucia
authors: L
authors: Appendino
mesh_terms: D000328:Adult; D000368:Aged; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000000981:diagnostic imaging*; D015588:Observer Variation; D012039:Regional Blood Flow / Q000502:physiology; D013122:Spinal Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D013131:Spine / Q000098:blood supply; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods
keywords: Doppler; Jugular veins; Multiple sclerosis; Ultrasonography; Venous insufficiency