Document Detail


Jugular veins in transient global amnesia: innocent bystanders.
MedLine Citation:
PMID:  22811457     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Transient global amnesia (TGA) has been associated with an increased prevalence of internal jugular valve insufficiency and many patients report Valsalva-associated maneuvers before TGA onset. These findings have led to the assumption of hemodynamic alterations in intracranial veins inducing focal hippocampal ischemia. We investigated this hypothesis in patients with TGA and control subjects.
METHODS: Seventy-five patients with TGA and 75 age- and sex-matched healthy subjects were enrolled into a cross-sectional study. Extracranial and transcranial high-resolution venous echo-color-Doppler sonography was performed blindly in all patients and control subjects. Blood flow direction and velocities were recorded at the internal jugular veins, basal veins of Rosenthal, and vein of Galen, both at rest and during Valsalva-associated maneuvers.
RESULTS: Mean age of patients with TGA was 60.3±8.0 years (median, 60 years; range, 44-78 years); 44 (59%) were female (female/male ratio: 1.42). Internal jugular valve insufficiency (left, right, or bilateral) was found to be more frequent in patients with TGA than in control subjects: 53 (70.7%) versus 22 (29.3%; P<0.05). Blood flow velocities in the deep cerebral veins of patients with TGA did not differ from control subjects both at rest and during Valsalva-associated maneuvers. Intracranial venous reflux was neither observed in patients with TGA nor in control subjects despite unilateral or bilateral internal jugular valve insufficiency during prolonged and maximal Valsalva-associated maneuvers.
CONCLUSIONS: This study, although confirming the association between TGA and internal jugular valve insufficiency, challenges the hypothesis that cerebral venous congestion plays a significant role in the pathogenesis of TGA.
Authors:
Claudio Baracchini; Simone Tonello; Filippo Farina; Federica Viaro; Matteo Atzori; Enzo Ballotta; Renzo Manara
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Publication Detail:
Type:  Journal Article     Date:  2012-07-17
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  43     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-28     Completed Date:  2012-11-05     Revised Date:  2012-12-18    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2289-92     Citation Subset:  IM    
Affiliation:
Department of Neurological Sciences, University of Padua School of Medicine, Via Giustiniani, 5, 35128, Padova, Italy. claudiobaracchini@tin.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Amnesia, Transient Global / pathology*,  ultrasonography
Cerebral Veins / physiopathology,  ultrasonography
Cerebrovascular Circulation / physiology
Cross-Sectional Studies
Female
Hemodynamics / physiology
Hippocampus / blood supply
Humans
Jugular Veins / pathology*,  ultrasonography
Male
Middle Aged
Risk Factors
Ultrasonography, Doppler, Color
Valsalva Maneuver
Comments/Corrections
Comment In:
Stroke. 2012 Sep;43(9):2275-6   [PMID:  22821610 ]
Stroke. 2012 Nov;43(11):e165; author reply e166   [PMID:  22989502 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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