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Published on: July 5, 2024
Jugular valve incompetence in transient global amnesia. A problem revisited
Piergiorgio Lochner1, Max Nedelmann, Manfred Kaps
1Department of Neurology, Justus-Liebig University, Giessen, Germany; Department of Neurology, Krankenhaus Meran, Meran, Italy.
Summary
Internal jugular venous valve incompetence (IJVVI) is more common in transient global amnesia (TGA) patients, but it does not appear to affect intracranial venous flow, questioning its role in TGA.
Area of Science:
- Neurology
- Vascular Medicine
- Medical Imaging
Background:
- Transient global amnesia (TGA) is a neurological condition with debated pathophysiology.
- Cerebral venous congestion from internal jugular venous valve incompetence (IJVVI) during Valsalva maneuver (VM) has been proposed as a TGA trigger.
Purpose of the Study:
- To investigate the hemodynamic effects of postural changes on IJVVI.
- To assess IJVVI and intracranial venous flow in TGA patients versus controls.
Main Methods:
- Extracranial color-coded duplex sonography assessed IJVVI during VM in 28 TGA patients and 25 controls.
- Transcranial sonography measured basal vein Rosenthal flow velocities at rest and during VM.
- Measurements were taken in supine and sitting positions.
Main Results:
- IJVVI was significantly more prevalent in TGA patients (68%) than controls (28%) in the supine position.
- Body position did not influence IJVVI detection.
- No significant differences in intracranial venous flow velocities were observed between TGA patients and controls, or between individuals with or without IJVVI.
Conclusions:
- A higher incidence of IJVVI in TGA patients was confirmed.
- The lack of difference in intracranial venous circulation challenges the hypothesis that IJVVI directly causes TGA.
- Further research is needed to elucidate the mechanisms underlying TGA.
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