Jugular sizes

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Jugular sizes

Postby panAmerica » Tue Sep 07, 2010 5:31 am

I'm not sure if it was posted anywhere but i had problems to understand the results of my MRV and ultrasound. So i searched for a paper describing the normal size of jugular veins here it is: Prediction of a small internal jugular vein by external jugular http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2044.1997.078-az0076.x/pdf

Internal jugularis
Mean diameter is ~17mm
Range in CI 95%: 15.8 - 19.1 mm
Range total: 4-30

external jugularis
Mean diameter is ~ 9 mm
Range in CI 95%: 8.2 - 10.5 mm
Range total: 0-16

Important: If you have big external jugulars your internal should be smaller and vise versa

This numbers were measured at anaestethic persons with head 10° down. Flat lying people will have smaller diameters but i couldn't access the according paper.[/b]
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Postby AlmostClever » Tue Sep 07, 2010 6:28 am

panAmerica:

I've seen the same paper and countless others in trying to determine what size an average jugular vein should be...

Dr. Sclafani answered 8-15 mm (for the IJV I assume) and gave an approximation of blood flow volume as well. (p.177? of his thread)

The IJV's drain the brain so a large external might indicate a small internal which could be a problem!

I wonder about the possibility that many of us have IJV's that are just too small?

My elementary knowledge of fluid flow tells me that only so much fluid can get through a certain sized pipe under a given pressure.

Would it be sound to think that jugulars which were too small would be insufficient to maintain adequate drainage without reflux? even without any stenosis?

Do we stent the entire length of the vein to increase flow capacity? How high do we need to go?

A/C
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Postby Cece » Tue Sep 07, 2010 8:44 am

Are you thinking hypoplasia (where the vein "never grew up to be an adult-sized vein")? DrS addressed this, months back, but his position was, I think, that they weren't seeing much of it. Based on the fact that hypoplasic lumbar veins are currently untreatable, I'd assume that they can't do much for a hypoplasic IJV either.
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Postby 1eye » Tue Sep 07, 2010 6:34 pm

AlmostClever wrote:Do we stent the entire length of the vein to increase flow capacity? How high do we need to go?

A/C


This would be a shunt. Commonly used in hydrocephalus. I'm probably old enough that I don't care much about the cosmetics of it.
"Try - Just A Little Bit Harder" - Janis Joplin
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Vein grafts/replacement?

Postby smokey » Tue Sep 07, 2010 10:12 pm

Remember this one?

This is a radical solution, but......

http://www.youtube.com/watch?v=l9syfTlcTrs

Smokey.
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Postby costumenastional » Tue Sep 07, 2010 10:19 pm

Pre op doppler:
Highly advanced stenosis of both of the jugular veins with a minimum diameter of Left - 0.03 mm and Right - 0,3mm, V. Vertebralis sin. -2.5mm, V. Vertebralis dex.

Doppler post op:
Lying position: V Jugularis sin diameter 5mm and V Jugularis dex diameter 4.3mm
Sitting position:V Jugularis sin diameter 2.5mm and V Jugularis dex diameter 2mm
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Postby Frank » Wed Sep 08, 2010 3:42 pm

Regarding the hypoplasia, I was diagnosed with a hypoplastic left IJV (sorry I dont know the exact diameter) but Prof Vogl said, that it would be possible to dilate it with the usual ballooning procedure...

--Frank
Treatment: Gilenya since 01/2011, CCSVI both IJV ballooned 09/2010, Tysabri stopped after 24 Infusions and positive JCV antibody test, after LDN, ABX Wheldon Regime for 1 year.
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Postby Cece » Wed Sep 08, 2010 3:48 pm

Interesting, Frank, that is good news.
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