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Updated: May 30, 2026

Standing Neurophysiological Assessment of Lower Extremity Muscles Post-Stroke
Published on: July 26, 2021
No cerebral or cervical venous insufficiency in US veterans with multiple sclerosis
Ellen Marder1, Pramod Gupta, Benjamin M Greenberg
1Neurology Section, VA North Texas Health Care System, Medical Service, Dallas VA Medical Center, 4500 South Lancaster Rd, Dallas, TX 75216, USA.
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.
Design:
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.
Setting:
Academic MS center.
Patients:
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.
Main Outcome Measures:
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.
Conclusion:
This study does not support the theory that chronic cerebral venous insufficiency exists in MS.
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