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Table 2 Doppler parameters that detect five anomalous venous hemodynamic criteria affecting cerebrospinal venous return a

From: Efficacy and safety of venous angioplasty of the extracranial veins for multiple sclerosis. Brave dreams study (brain venous drainage exploited against multiple sclerosis): study protocol for a randomized controlled trial

(1)

 Reflux-bidirectional flow constantly present in the IJV and/or vertebral vein with the patient in both examination positions (sitting and supine posture) in at least one of the three landmarks (J1, J2, J3)

(2)

 Reflux-bidirectional flow in the intracranial veins: The presence of intracranial venous reflux is diagnosed when there is reflux on the Rosenthal’s vein and/or transverse sinus and/or cavernous sinus and/or superior or inferior petrosus sinus

(3)

 B-mode and M-mode demonstration of intraluminal defects (septa, valvular malformations, double-channel) and/or cross-sectional area <0.3 cm2

(4)

 Absent flow in internal jugular veins and/or vertebral veins after repeated deep inhalations with the patient in both examination positions (sitting and supine) in at least one of the three landmarks (J1, J2, J3). The finding of absence of flow in only one body position becomes a useful criterion even if reflux-bidirectional flow is found in the other position.

(5)

 Cross-sectional area of the IJV at J2 point greater in sitting that in supine posture

  1. aAs described by Zamboni [12]. At least two of the five anomalous venous hemodynamic criteria must be present for the diagnosis of chronic cerebrospinal venous insufficiency (CCSVI).