Jugular reflux and white matter changes

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

Jugular reflux and white matter changes

Postby gibbledygook » Wed May 11, 2011 12:32 am

Apologies if this is here somewhere already:

Ann Neurol. 2011 Mar;69(3):553-9. doi: 10.1002/ana.22276. Epub 2011 Mar 9.

More severe white matter changes in the elderly with jugular venous reflux.

Chung CP, Wang PN, Wu YH, Tsao YC, Sheng WY, Lin KN, Lin SJ, Hu HH.


Source

Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan.


Abstract

OBJECTIVE:

The etiology of age-related white matter changes is unclear. Cerebral white matter changes on magnetic resonance imaging (MRI) and progressive dementia have been reported in patients with dural arteriovenous fistulas of the sigmoid sinus. The frequency of jugular venous reflux, which mimics a dural arteriovenous fistula, significantly increases with age. We investigated whether jugular venous reflux was associated with the severity of age-related white matter changes in 97 persons (aged 55-90 years, mean [standard deviation]: 75.77 [8.19] years; 55 men) from a medical center memory clinic.

METHODS:

MRI (1.5T) and the semiquantitative Scheltens scale were used to investigate the severity of white matter changes. Subjects were classified into 3 groups (no, mild, and severe jugular venous reflux) by duplex ultrasonography.

RESULTS:

Subjects with severe jugular venous reflux had more severe age-related white matter changes in occipital subcortical, thalamus, pontine, and summed infratentorial regions compared with subjects with no jugular venous reflux (all corrected p < 0.0166), especially subjects aged ≥75 years (corrected p < 0.0166 in occipital subcortical; corrected p < 0.0001 in pontine and summed infratentorial regions). In subjects ≥75 years, we further noted that the whole brain age-related white matter changes rating scores were higher in the severe jugular venous reflux group than the no and mild jugular venous reflux groups (corrected p < 0.0166).

INTERPRETATION:

People with severe jugular venous reflux exhibit more severe age-related white matter changes, especially in caudal brain regions. We also demonstrate age-dependent jugular venous reflux effects on the severity of age-related white matter changes. These findings may provide new clues into the pathophysiology of age-related white matter changes. ANN NEUROL 2011

http://www.ncbi.nlm.nih.gov/pubmed/21391231
3 years antibiotics, 06/09 bilateral jug stents at C1, 05/11 ballooning of both jug valves, 07/12 stenting of renal vein, azygos & jug valve ballooning,
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gibbledygook
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Postby Cece » Wed May 11, 2011 6:25 am

This is the other type of jugular reflux, resulting from valves that are weakened and allow blood flow back from the heart. (CCSVI being when the valves are overly thick and stuck as blockages.)

We're creating a situation, post-treatment, where we have no valves at all and so might end up with this sort of reflux. But it is thought to be better than the situation when the outflow obstruction is in place.

It is important from this research that jugular reflux can result in age-related white matter lesions. There is a connection between the blood flow from our brains and the health of our brains.
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