Document Type : Original Article


1 Middle Euphrates Neuroscience Center, School of Medicine, University of Kufa, Najaf, ‎Iraq

2 Department of Anatomical Sciences, School of Medical Sciences, Tarbiat Modares ‎University, Tehran, Iran

3 Middle Euphrates Research Center, School of Medicine, University of Kufa, Najaf, Iraq


Background: Multiple sclerosis (MS) is a chronic inflammatory dissemination disease affecting the central nervous system, immunological reaction is the main underlying cause according to description by Jean Martin Charcot. Recently, chronic cerebrospinal venous insufficiency ( CCSVI) has been considered as a potential cause of MS; this study has been conducted in order to test this hypothesis by High resolution Duplex Color Doppler Sonography among Iraqi MS patients.Methods: Randomized cross sectional blind controlled study conducted on 42 Iraqi participants (23 relapsing remitting MS patients and 19 healthy controls) whom fulfilled the inclusion and exclusion criteria, and  had been examined blindly with color Doppler and pulse wave Doppler , CCVSI has been assessed according to Zamboni sonography criteria blindly by an expert sonographist.  The examination was performed in supine and sitting positions after 5 minutes rest so as to reach a steady state, general gray scale U/S with 6-10 MHz linear probe study for both sides of the neck  was done in order to assess internal jugular vein ( IJV) obstruction, state of jugular valves, measurement of cross sectional area of proximal part of internal jugular veins, assessment of blood flow whether present or absent and time measurement  of  reverse flow in both of the  internal jugular and vertebral veins (VVs) during the Valsalva maneuver (VM). CCSVI is considered positive in presence of:  two or more of its criteria. Results: There was no significant differences in all of the parameters and criteria of CCSVI between the healthy control and the MS study group.Conclusion: The conclusion  of this study that the results does not support any significant contribution of CCSVI in MS pathogenesis.