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Clinical Classification and Collateral Circulation in Chronic Cerebrospinal Venous Insufficiency
Zhongao Wang1,2,3, Jiayue Ding1,2,3, Chaobo Bai1,2,3
1Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Frontiers in Neurology
|October 19, 2020
Summary
Chronic cerebrospinal venous insufficiency (CCSVI) involves extracranial venous system issues. This study quantifies CCSVI classifications and imaging, highlighting the vertebral venous system as key collateral circulation for assessing internal jugular venous stenosis.
Area of Science:
- Neuroscience
- Vascular Biology
- Medical Imaging
Background:
- The extracranial cerebrospinal venous system, crucial for cerebral circulation, remains under-recognized.
- Chronic cerebrospinal venous insufficiency (CCSVI) impacts this system, necessitating quantitative analysis of its clinical and imaging features.
Purpose of the Study:
- To quantitatively analyze the clinical classification and imaging characteristics of chronic cerebrospinal venous insufficiency (CCSVI).
- To evaluate the role of the vertebral venous system as collateral circulation in CCSVI.
Main Methods:
- 128 patients diagnosed with CCSVI via jugular ultrasound and contrast-enhanced magnetic resonance venography (CE-MRV) were studied.
- Computed tomography venography (CTV) assessed extraluminal compression, internal jugular venous stenosis (IJVS) degree, and vertebral venous collateral circulation.
Main Results:
- Common causes of IJVS included osseous compression (78.95%) and carotid artery involvement (24.21%).
- Non-compression CCSVI subtypes included high jugular bulb (77.27%) and internal jugular vein thrombosis (14.55%).
- Severe IJVS correlated with increased vertebral venous expansion, and vice versa (p < 0.001).
Conclusions:
- A multimodal diagnostic approach is essential for accurate CCSVI diagnosis.
- The vertebral venous system serves as significant collateral circulation in CCSVI and may indicate IJVS severity.
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