Document Detail


Internal jugular vein valve incompetence and intracranial venous anatomy in transient global amnesia.
MedLine Citation:
PMID:  15774436     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recently a causal relation between internal jugular vein valve incompetence (IJVVI) and transient global amnesia (TGA) has been suggested. IJVVI is postulated to provoke a transient mesiotemporal ischaemia by venous congestion. This mechanism requires a patent venous pathway from the affected IJV through the transverse sinus, confluens, straight sinus (SS), vein of Galen into the basal vein of Rosenthal and the internal cerebral veins. OBJECTIVE: To study IJVVI in TGA patients in relation to the intracranial venous anatomy. METHODS: IJVVI was defined if a repeated Valsalva manoeuvre (VM) led to a retrograde jugular flow detected by extracranial duplex ultrasound. Non-contrast venous MR angiography (MRA) was performed to analyse intracranial drainage patterns of the SS in relation to the side of the IJVVI. SS drainage was differentiated into three groups: predominantly right, left, and bilateral drainage. Ultrasound studies were performed in 25 TGA patients and 85 age matched controls. Twenty patients underwent venous MRA. RESULTS: Sixty eight per cent of patients and 33% of controls showed unilateral or bilateral IJVVI (p = 0.0025). In 36% of patients a TGA preceding VM was reported. Drainage pattern of SS and side of IJVVI corresponded in five of eight patients (63%) with VM and four of 12 patients without VM (33%, p = 0.0994). CONCLUSION: Our study confirms the significantly higher prevalence of IJVVI in TGA patients. However, no specific IJVVI related intracranial venous drainage patterns could be found to further support the hypothesis of a direct causal relation between IJVVI and TGA.
Authors:
S J Schreiber; F Doepp; R Klingebiel; J M Valdueza
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurology, neurosurgery, and psychiatry     Volume:  76     ISSN:  0022-3050     ISO Abbreviation:  J. Neurol. Neurosurg. Psychiatr.     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-03-18     Completed Date:  2005-05-10     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  2985191R     Medline TA:  J Neurol Neurosurg Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  509-13     Citation Subset:  IM    
Affiliation:
Department of Neurology, University Hospital Charité, Schumannstrasse 20/21, 10117 Berlin, Germany. Stephan.Schreiber@charite.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Amnesia, Transient Global / etiology*,  physiopathology*
Brain / blood supply,  physiopathology,  radiography
Brain Ischemia / etiology,  physiopathology
Cerebrovascular Circulation*
Female
Humans
Jugular Veins / anatomy & histology*,  physiopathology*,  ultrasonography
Magnetic Resonance Angiography
Male
Middle Aged
Prospective Studies
Severity of Illness Index
Ultrasonography, Doppler, Duplex
Valsalva Maneuver / physiology
Venous Insufficiency / complications*,  diagnosis,  physiopathology*
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