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    Area of Science:

    • Vascular Medicine
    • Neurology
    • Radiology

    Background:

    • Chronic cerebrospinal venous insufficiency (CCSVI) is a condition linked to venous abnormalities.
    • Internal jugular vein (IJV) diameter and reflux are key indicators in CCSVI assessment.
    • Multiple sclerosis (MS) has been investigated for potential associations with CCSVI.

    Purpose of the Study:

    • To determine the prevalence of reflux in internal jugular veins (IJV) using the Valsalva maneuver.
    • To explore the association between IJV reflux and CCSVI in patients with MS.

    Main Methods:

    • 393 patients with MS and CCSVI were recruited.
    • EchoColor Doppler was used to measure IJV diameter at the subclavian confluence (JSd).
    • Participants were categorized into three groups based on JSd: <6 mm, 6-10 mm, and ≥10 mm.

    Main Results:

    • Mean IJV diameter was 8 ± 2 mm; no significant left/right differences were found.
    • Veins ≥10 mm were more prevalent than veins ≤6 mm.
    • Significant differences in the prevalence of JSd≥10 mm were observed between males (30.7%) and females (16.7%). The Valsalva+/Valsalva- ratio in the JSd≥10 mm group was approximately 1:2 for females and 1:3 for males. Aged females in the JSd≥10 mm group had larger jugular diameters than younger females.

    Conclusions:

    • Females with CCSVI and MS may exhibit 'wall Miopragia,' indicated by a higher Valsalva+/Valsalva- ratio compared to males in the JSd≥10 mm group.
    • Bilateral jugular dilatations and increased reflux prevalence with larger IJV diameter support the 'wall Miopragia' hypothesis.
    • Further research is needed to confirm these findings regarding IJV dilatation and jugular reflux in MS patients.