Birgit Betina Ertl-Wagner MD, Presenter: Scientific Advisory Board, Koninklijke Philips Electronics NV

Inga Koerte MD, Abstract Co-Author: Nothing to Disclose

Astrid Blaschek, Abstract Co-Author: Nothing to Disclose

Tania Kuempfel, Abstract Co-Author: Nothing to Disclose

Florian Heinen, Abstract Co-Author: Nothing to Disclose

Noam Alperin PhD, Abstract Co-Author: Stockholder, Alperin Noninvasive Diagnostics, Inc

Maximilian F. Reiser MD, Abstract Co-Author: Nothing to Disclose

Reinhard Hohlfeld, Abstract Co-Author: Nothing to Disclose

There has recently been considerable discussion regarding venous drainage patterns in multiple sclerosis (MS) patients with several publications claiming chronic cerebrospinal venous insufficiency to be exclusively seen in MS and to even play a causative role in the disease. We aimed to investigate venous drainage pattern in patients with MS and compare it to a cohort of normal controls, as well as to patients with migraine and mild traumatic brain injury.

27 patients with MS (21 female, age 12 to 59 yrs, mean disease duration 8.4 ± 8.5 years) and 27 age- and gender-matched healthy controls (21 female, age 12 to 60 years) were investigated with velocity-encoded cine-phase contrast scans and a 2D time-of-flight MR-venography of the cervicocranial region on a 3T MRI. The data were compared to 26 patients with chronic migraine headaches (19 female, age 17 to 62 years) and 15 patients with mild traumatic brain injury (4 female, age 20 to 49 years) previously investigated with the same protocol. The degree of primary and secondary venous outflow in relation to the tCBF was compared both quantitatively and qualitatively. Data were analyzed with linear regression models.

There was a significantly increased secondary venous outflow in patients with MS compared to the healthy controls both qualitatively (p < 0.001) and quantitatively (p < 0.013). However, this significant increase in venous drainage was observed in migraine patients and in patients with mild traumatic brain injury as well.

Even though our data indicate that there is an altered venous drainage in patients with MS, the comparison to other disease entities such as migraine and mild traumatic brain injury suggest these alterations not to be disease-specific, but rather an epiphenomenon.

As alterations in venous outflow is shown to be a phenomenon, which is not specific to MS, but rather also occurs in other disease entities, vascular interventions such as venous stenting does not app

Ertl-Wagner, B, Koerte, I, Blaschek, A, Kuempfel, T, Heinen, F, Alperin, N, Reiser, M, Hohlfeld, R, Increased Secondary Venous Drainage in Patients with Multiple Sclerosis: Is It an Epiphenomenon?  .  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11009860.html