Internal jugular venous abnormalities in transient monocular blindness

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

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: 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 venule dilatation and higher frequency of jugular venous reflux (JVR). This study aimed to elucidate whether there are anatomical abnormalities at internal jugular vein (IJV) in TMB patients that would contribute to impaired cerebral venous drainage and consequent ocular venous hypertension.Methods: Contrast-enhanced axial T1-weighted magnetic resonance imaging (MRI) was performed in 23 TMB patients who had no carotid stenosis and 23 age- and sex-matched controls. The veins were assessed at the upper IJV (at C1-3 level) and the middle IJV (at C3-5 level). Grading of IJV compression/stenosis was determined bilaterally as follows: 0 = normal round or ovoid appearance; 1 = mild flattening; 2 = moderate flattening; and 3 = severe flattening or not visualized.Results: There was significantly more moderate or severe IJV compression/stenosis in the TMB patients at the left upper IJV level and the bilateral middle IJV level. Defining venous compression/stenosis scores ≥ 2 as a significant cerebral venous outflow impairment, TMB patients were found to have higher frequency of significant venous outflow impairment at the upper IJV level (56.5% vs. 8.7%, p = 0.0005) and the middle IJV level (69.6% vs. 21.7%, p=0.0011).Conclusions: TMB Patients with the absence of carotid stenosis had higher frequency and greater severity of IJV compression/stenosis which could impair cerebral venous outflow. Our results provide evidence supporting that the cerebral venous outflow abnormality is one of the etiologies of TMB.

Original languageEnglish
Article number94
JournalBMC Neurology
Volume13
DOIs
Publication statusPublished - Jul 22 2013
Externally publishedYes

Keywords

  • Chronic cerebrospinal venous insufficiency
  • Internal jugular vein
  • Jugular venous reflux
  • Transient monocular blindness
  • Venous hypertension
  • Venous outflow abnormalities

ASJC Scopus subject areas

  • Clinical Neurology

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