drsclafani wrote:
All i see at that link is a single image of an MRvenogram. It does not show much of interest and does not visualize the more essential area where most of the stenoses occur
so it is not possible for me to advise you since i do not have sufficient informoation to help you. Neither the clinical information that would help me decide whether you should proceed to the next step. I generally do not use MRV to decide whether to perform venography. Of course, there are signs on MRVenograms that can point to ccsvi, but in your case the single image was insufficient.
s
Hi, Dr Sclafani
You will see herunder two reports : scanner and MRI.
I don't know if you could tell something more.
The conclusion of my vascular surgeon (absolutly not aware of ccsvi) was : no stenose on jugular veins, reduced diamater was due to a reduced lateral venous sinus, congenital, nothing to do ...
Of course, I can't be satisfied with a such answer.
Is it nessecary to do others exams like a Doppler protocol Zamboni ?
How to check azygos vein ? I have a medular MS.
What do you think ?
Many thanks
CT-scan NECK
INDICATION:
Evaluation of a size asymmetry of the jugular veins.
TECHNIQUE
Purchase volume focuses on the regions of the brain, cervical and upper thoracic, immediately after intravenous injection of contrast. (DLP = 1283.25 mGy-cm)
RESULTS:
The exploration of the brain parenchyma does not show any abnormal density or abnormal enhancement.
No detectable defect size branches of Polygon of Willis.
The superior longitudinal veinous sinus opacified satisfactorily and drains almost entirely into the right lateral sinus.
The jugular foramen measured 73 mm2 right, left 36 mm2.
It confirms the size asymmetry of the jugular veins, the right jugular vein has a surface of 48 mm2 to 145 mm2.
The left jugular vein has an axial surface at least 15 mm2 compared to the anterior border of the lateral process of C2 and the posterior border of the styloid process (pictures 357-400 series 2).
The maximum size of the left jugular vein was measured at 95 mm2.
This asymmetry of size seems to be related to the size asymmetry of lateral venous sinus, although the recess between the C2 of the styloid process has a low antero-posterior diameter (4 mm).
Moreover, the subclavian veins in the innominate vein have a normal size.
It is not viewed abnormal opacification of the aortic arch (the left vertebral artery arises directly from the aortic arch).
No abnormal contrast enhancement visible in the light of the upper aero-digestive tract.
Integrity of the thyroid and salivary glands.
No adénomégalie lateral cervical spinal or supraclavicular.
No obvious change of the lung apex.
No mediastinal mass syndrome higher.
CONCLUSION:
Asymmetry confirmed for the jugular veins with a size asymmetry of constitutional lateral intracranial venous sinuses.
MRI ANGIO-AND VENOUS BLOOD OF THE CERVICAL REGION
INDICATION:
Review of headache.
TECHNICAL:
Sagittal Tl Axial FLAIR, diffusion, axial gadolinium Tl centered on the brain. Angio-MRI with gadolinium injection centered in the cervical region during the arterial and venous time.
RESULT:
1 - Brain: Presence of two punctiform hyperintense T2 FLAIR infra-tentorial.
In Supratentorial, we visualize a beach on T2 subcortical left temporal, 12 mm long axis associated with a hyperintense cortical than 4 mm in diameter and 4 mm right frontal peri-ventricular diameter front left. These violations do not enhance démyélmisantes during injection of contrast, compliance with apparent diffusion coefficient.
2 - Neck: No obvious abnormality of the aortic arch. Birth of the left vertebral artery directly from the aortic arch. The supra-aortic arteries are of normal size and signal abnormalities without their weapons. No anomaly visible gauge of the branches of the circle of Willis.
The venous vascular exploration of the neck size of the asymmetry found in appearance congenital sinus venous side with a predominance of right side.
It still looks laminate the left jugular vein high in its course without real retro-styloid extrinsic compression or intraluminal signal abnormality.
The subclavian vein and innominate venous trunks are of satisfactory size and permeability.
CONCLUSION:
Presence of some demyelinating infra and supra-tentorial and does not enhance on injection of contrast.
Size asymmetry of the jugular veins of congenital pace without significant extrinsic compression.