Characteristics of the venous drainage of the central nervous system in patients with multiple sclerosis

In this clinical observational study 157 patients with MS, without disease modifying therapy, and 56 healthy participants were included. The ulstasonographic examination of the neck blood vessels and deep brain veins was performed. Insufficient drainage was defined by presence of: chronic cerebrospinal vein insuficiency; and/or segmental stenosis of internal jugular vein; and/or reflux in internal jugular vein during Valsalva maneuvre. In the patient group we determined: course of the disease, functional disability determined by EDSS (Expanded Disability Status Scale), disease progression determined by MSSS (Multiple Sclerosis Severity Score). Frequency of at least one of the phenotypes was significantly higher in patients with secundary progressive compared to patients with relapsing–remitting course. Mean values of EDSS and MSSS were significantly higher in patients with at least one of investigated phenotypes compared to patients without the presence of these phenotypes. Insufficient venous drainage of central nervous system (CNS) was significantly more frequent in patients with longer duration of disease, higher grade of functional disability and secondary progressive form of MS.