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Internal jugular venous abnormalities in transient monocular blindness.

Chun-Yu Cheng¹, Feng-Chi Chang, A-Ching Chao

¹Department of Neurology, Neurological Institute, Taipei -Veterans General Hospital, Taipei, Taiwan.

|July 24, 2013

Summary

Transient monocular blindness (TMB) patients without carotid stenosis show higher rates of internal jugular vein (IJV) compression. This anatomical abnormality may impair cerebral venous outflow, contributing to TMB.

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Area of Science:

Neuroscience
Vascular Medicine
Ophthalmology

Background:

Transient monocular blindness (TMB) without carotid stenosis is linked to ocular venous hypertension.
Increased retrobulbar vascular resistance, retinal venule dilatation, and jugular venous reflux (JVR) are implicated.
This study investigates anatomical abnormalities in the internal jugular vein (IJV) in TMB patients.

Purpose of the Study:

To determine if anatomical abnormalities of the IJV contribute to impaired cerebral venous drainage in TMB patients.
To assess the relationship between IJV compression and ocular venous hypertension in TMB.
To identify potential causes of TMB in the absence of carotid stenosis.

Main Methods:

Contrast-enhanced axial T1-weighted MRI was used.
23 TMB patients without carotid stenosis and 23 controls were included.
IJV compression/stenosis was graded bilaterally at upper (C1-3) and middle (C3-5) levels.

Main Results:

TMB patients exhibited significantly more moderate or severe IJV compression/stenosis.
Higher frequency of significant venous outflow impairment was observed in TMB patients at both upper (56.5% vs. 8.7%) and middle (69.6% vs. 21.7%) IJV levels.
These differences were statistically significant (p < 0.0011).

Conclusions:

TMB patients without carotid stenosis have a higher frequency and severity of IJV compression/stenosis.
This IJV abnormality can impair cerebral venous outflow.
Cerebral venous outflow abnormality is a potential etiology of TMB.