Background: High prevalence of valve absence was found in the internal jugular vein
(IJV) of healthy volunteers by means of M-mode high-resolution Echo Colour Doppler (ECD).
However, the prevalence of valve in neurovascular disorders linked to Chronic Cerebrospinal
Venous Insufficiency (CCSVI) is still unknown.
Methods: A cohort of 83 Healthy Controls (HC), 71 Multiple Sclerosis (MS), 99 Inner Ear Disorders
(IED) underwent ECD investigation of the IJV valve, including M-mode evaluation and related
hemodynamics. The primary outcome measure was characterization of valve presence, morphology
and motility, whereas the secondary outcome was the rate of flow alteration.
Results: Bilateral valve presence was found in 38% of HC, 58% of MS and 25% of IED, whereas,
bilateral valve absence was recorded in 16% of HC, 10% of MS and 31% of IED (p<0.003). Bicuspid
morphology was more prevalent in HC 56%, while monocusp was more prevalent in patients:
75% MS and 57% IED (p<0.0001). The main finding was the presence of mobile valve leaflets
in 98% of HC, contrarily fixed valve leaflets were recorded in 82% of MS and in 41% of IED,
Finally, by stratifying the entire cohort according to the presence of mobile and not mobile valve
leaflets, normal monodirectional and phasic flow were commonly found in the mobile leaflets
Conclusion: In patients with miscellaneous neurological disorders, a significant higher rate of defective
valves was found with respect to HC. The latter condition is strongly associated to brain
outflow abnormalities described in CCSVI condition.