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Venous involvement in neurological disorders and aging

The extracranial venous system is complex and variable between individuals. Until recently, these variations were acknowledged as developmental variants and were not considered pathological findings. However, in the last decade, the presence and severity of uni- or bi-lateral jugular venous reflux have been linked to several central nervous system (CNS) disorders such as transient global amnesia, transient monocular blindness, cough headache, primary exertional headache and most recently to Alzheimer's disease. The most recent introduction of a composite criteria-based vascular condition named chronic cerebrospinal venous insufficiency (CCSVI) that was originally linked to multiple sclerosis increased the interest in better understanding of the role of the extracranial venous system in the pathophysiology of CNS disorders. The ultimate cause-consequence relationship between these conditions and CNS disorders has not been firmly established and further research is needed. This article collection in BMC Medicine and BMC Neurology aims to synthesize the current concepts and most recent findings concerning the evaluation, etiology, pathophysiology and clinical relevance of the potential involvement of the extracranial venous system in the pathology of multiple CNS disorders and in aging. All articles in this cross-journal collection have been independently prepared by the authors and have been subject to the standard peer-review processes of the journals.

  1. Research article

    Multimodal noninvasive and invasive imaging of extracranial venous abnormalities indicative of CCSVI: Results of the PREMiSe pilot study

    There is no established noninvasive or invasive diagnostic imaging modality at present that can serve as a ‘gold standard’ or “benchmark” for the detection of the venous anomalies, indicative of chronic cerebr...

    Robert Zivadinov, Yuval Karmon, Kresimir Dolic, Jesper Hagemeier, Karen Marr, Vesela Valnarov, Cheryl L Kennedy, David Hojnacki, Ellen M Carl, L Nelson Hopkins, Elad I Levy, Bianca Weinstock-Guttman and Adnan H Siddiqui

    BMC Neurology 2013 13:151

    Published on: 20 October 2013

  2. Review

    Venous endothelial injury in central nervous system diseases

    The role of the venous system in the pathogenesis of inflammatory neurological/neurodegenerative diseases remains largely unknown and underinvestigated. Aside from cerebral venous infarcts, thromboembolic even...

    Jonathan S Alexander, Leonard Prouty, Ikuo Tsunoda, Chaitanya Vijay Ganta and Alireza Minagar

    BMC Medicine 2013 11:219

    Published on: 11 October 2013

  3. Research article

    Cognitive impairment and “invisible symptoms” are not associated with CCSVI in MS

    We investigated the association between chronic cerebrospinal venous insufficiency (CCSVI) and cognitive impairment (CI) in multiple sclerosis (MS). Moreover, we evaluated the association between CCSVI and oth...

    Carmela Leone, Emanuele D’Amico, Sabina Cilia, Alessandra Nicoletti, Luigi Di Pino and Francesco Patti

    BMC Neurology 2013 13:97

    Published on: 27 July 2013

  4. Research article

    Internal jugular venous abnormalities in transient monocular blindness

    The etiology of transient monocular blindness (TMB) in patients without carotid stenosis has been linked to ocular venous hypertension, for their increased retrobulbar vascular resistance, sustained retinal ve...

    Chun-Yu Cheng, Feng-Chi Chang, A-Ching Chao, Chih-Ping Chung and Han-Hwa Hu

    BMC Neurology 2013 13:94

    Published on: 22 July 2013

  5. Research article

    Chronic cerebrospinal venous insufficiency is not associated with cognitive impairment in multiple sclerosis

    Chronic cerebrospinal venous insufficiency (CCSVI) has been reported in multiple sclerosis (MS) yet its significance in relation to cognitive function is undetermined.

    Ralph HB Benedict, Bianca Weinstock-Guttmam, Karen Marr, Vesela Valnarov, Cheryl Kennedy, Ellen Carl, Christina Brooks, David Hojnacki and Robert Zivadinov

    BMC Medicine 2013 11:167

    Published on: 18 July 2013

  6. Research article

    An ultrasound model to calculate the brain blood outflow through collateral vessels: a pilot study

    The quantification of the flow returning from the head through the cervical veins and the collaterals of the internal jugular vein (IJV), is becoming of prominent interest in clinical practice. We developed a ...

    Paolo Zamboni, Francesco Sisini, Erica Menegatti, Angelo Taibi, Anna Maria Malagoni, Sandra Morovic and Mauro Gambaccini

    BMC Neurology 2013 13:81

    Published on: 11 July 2013

  7. Review

    The role of noninvasive and invasive diagnostic imaging techniques for detection of extra-cranial venous system anomalies and developmental variants

    The extra-cranial venous system is complex and not well studied in comparison to the peripheral venous system. A newly proposed vascular condition, named chronic cerebrospinal venous insufficiency (CCSVI), des...

    Kresimir Dolic, Adnan H Siddiqui, Yuval Karmon, Karen Marr and Robert Zivadinov

    BMC Medicine 2013 11:155

    Published on: 27 June 2013

  8. Research article

    Jugular venous reflux and plasma endothelin-1 are associated with cough syncope: a case control pilot study

    Jugular venous reflux (JVR) has been reported to cause cough syncope via retrograde-transmitted venous hypertension and consequently decreased cerebral blood flow (CBF). Unmatched frequencies of JVR and cough ...

    Chih-Ping Chung, Chun-Yu Cheng, Robert Zivadinov, Wei-Chih Chen, Wen-Yung Sheng, Yu-Chin Lee, Han-Hwa Hu, Hung-Yi Hsu and Kuang-Yao Yang

    BMC Neurology 2013 13:9

    Published on: 16 January 2013