EXAM PERFORMED: Internal Jugular Vein Ultrasound
Indication for Exam: Question Cerebrospinal Venous Insufficency
FINDINGS: Bilateral internal jugular veins were imaged using duplex colorflow ultrasound. Both jugular veins appear patent with no obvious evidence of stenoses or obstruction(s). Both internal jugular veins low in the neck just above the clavicle showed questionably inverted venous valves producing some amount of reflux by colorflow ultrasound. The vertrebral veins were also examined bilaterally and appeared to show an increase in venous flow while patient ewsds in both the supine and sitting positions. The internal jugular veins appeared relatively normal in caliber in both the supine and sitting positions.
IMPRESSION: Questionable inverted venous valves in both internal jugular vein low n the neck with increased venous flow through the vertebral veins.
RECOMMENDATION: Might recommend MR venagram to further assess the cerebral spinal venous flow in hopes of determining whether these questionably inverted valves are true producing reflux or simply artifact on the ultrasound.
I have the cd of the doppler but I can't put the image here.
Understand that I will be the first person in Rochester, NY who has had the doppler done and I provided the protocol to the technician. I have also provided the MRV protocol to the radiologist who will be doing that test. So they have everything - including an MRI of my brain from last November showing the UBO's and meningeoma that was found in 1991 but hasn't changed over the years.
I have had MS since 1972 and had RRMS until 1999 when it changed to SPMS. Since 2007 I have had intermittent double vision which is now sustained and using a prism on one lens helps to be able to drive. I have a wide gait but using Ampyra helps walking and stamina.
I am working with my primary care physician and not my neurologist who I feel doesn't have the time for me. However because my pcp tells me not to get my hopes up, I am only using him to get the testing done.
He wouldn't know what's next as far as the MRV goes - I had to tell him what I have learned on my own. I don't know how it is being accepted by the IR. He gave himself a week to do some more studying up on what my doctor wanted done (for me). So I provided that IR with a stack of papers besides the protocols that I have found on www.patientslikeme.com
Now you have the full story. Sorry if it is not appropriate here - but I am alone in this pursuit. Thank you for your assistance in giving me a heads up on what to expect after the MRV and how venoplasty could correct the problem or not.