The cerebral veins collect blood into the dural sinuses and in turn redirected toward the main extracranial venous outflow routes: the internal jugular veins (IJVs) and the vertebral veins (VVs) system (Figure 1). The anatomical pathways of jugular drainage are well established.
Chronic cerebrospinal venous insufficiency (CCSVI) is a syndrome characterized by stenosies of the internal jugular and/or azygous veins (IJVs-AZ) with opening of collaterals and insufficient drainage proved by reduced cerebral blood flow and increased mean transit time in cerebral MRI perfusional study.
As far as the origin of venous narrowing is concerned, phlebographic studies of the IJVs and AZ systems demonstrated that venous stenoses were likely to be truncular venous malformations; mostly, they are intraluminal defects such as malformed valve, septa webs.
Figure 1 Schematic of the cerebrospinal venous system with the location and relative prevalence of extracranial and extravertebral venous stenosis. DMCVs, deep middle cerebral veins; TS, transversal sinus; CV, condylar veins; VV, vertebral veins; IJV, internal jugular vein; VP, vertebral plexus; SVC, superior vena cava: AZY, azygous vein
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