Morphol Embryol (Bucur). 1981 Jul-Sep;27(3):195-214.
Data regarding the typology and functional significance of the venous valves.
Many authors described in detail the morphological features of human venous valves, but less their functional architecture. The present study provides additional information concerning the valvular anatomy, to enable its functional interpretation. The previously reported data and the author's results showed the regional distribution and characteristics of venous valves in different areas of the human body. Certain findings suggested a reorganization after birth of the venous valves which are frequently met in fetus. The close relation between hemodynamic mechanisms and the blood guiding structures may explain the changes (disappearance or persistence) of venous valves in some areas after birth. Significance of the rudimentary folds, resembling valves, is not yet elucidated. Based on his observations, the author attempted a new classification of the veins. The relations between density and morphological peculiarities of venous valves in different vein types showed that the constant valves were always involved in the local hemodynamics. Bardeleben's principles referring to the location and topographical arrangement of venous valves can be applied only to certain areas of the limbs, but not to other regions. In this paper there are described and functionally interpreted the venous valves of all territories of the human body.
Cece wrote:I'd been under the impression that it was structural abnormalities of the walls of the veins that made up the most of CCSVI...you know, the missing jugulars, the thickened jugulars, the double jugulars. Dr. Sclafani says, no, it's mostly a valve issue.
ljelome wrote:Hi! i was wondering if u have valve issues then what would happen to the blood flow?
In my case, on my Doppler USG, the sonographer couldn't see my valves in both my jugular, but there's no reflux in both IJV. Or if u have no valves then the reflux only happens if u have valsava maneuver, is it like that?
So do you think i should do another Doppler USG to know whether there is reflux in my IJV when doing valsava maneuver?
Please help me, cause my doctor really don't know anything about CCSVI besides from the reading materials i gave him.
Thank you for your information.
ljelome wrote:Dear dr. Sclafani,
Thank you for your explanation...i have to read it many times in order to understand what you're saying. Pardon me, my english is not so good.
So you said that maybe my valve is there but it just can't be seen because maybe my valve is just very thin and move so quickly. If it is the case then does it mean that my valve is okay? Coz during my examination, as a comparison, my doctor had my healthy husband to be checked by the same Doppler USG, and we can see the valve very clearly in his IJV.
From my CT Venogram and Doppler USG result, my doctor said that there is no stenosis, no reflux, no absence flow in both IJV . But you said that "if the valve is obstructed, generally what happens is that the vein above the stenosis starts to dilate or enlarge. Slow flow or stasis (absence of outflow) occurs". Yes, in my right IJV my doctor noticed a slow flow in all part of the right IJV (from prox, mid to distal area). Could this slow flow happened because my doctor pressed my neck to hard during the examination?
And you said "This leads to reduced arterial inflow, poorer perfusion with oxygenated blood into the brain and reduction in cerebrospinal fluid drainage and possibly hydrocephalus." But my doctor said there is a hyperacceleration in my arterial flow? Does it mean an increased in arterial inflow?
You said "Additionally, when the muscles of the neck contract, they MAY cause the pressurization of the blood within the vein. In the presence of obstruction toward flow into the heart, this blood may jet into the skull and injure deep cerebral veins." I wonder what activities that can make my neck contract?
And if the obstruction in my IJV's valves is an absence of those valves, then what would happen to the blood flow or what is the impact then?
Oh dr. Sclafani, i'm sorry to ask u so many questions. I wish u could be my doctor:-)
Or maybe, i just have to see another sonographer then? Do you happen, by any chance, to know some one who can do this procedure accurately in Asia? Coz i live in Indonesia and there's never any CCSVI examination done here before, if it wasn't for me. There's so little case of MS here compare to the other countries in America or Europe or Australia.
Please dr. Sclafani, tell me what to do?
Thank you for your time and thank you for your quick reply.
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