Chronic cerebrospinal venous insufficiency in Ménière disease.

Phlebology. 2015 May;30(4):274-9. doi: 10.1177/0268355514526871. Epub 2014 Mar 4.
Di Berardino F1, Alpini DC2, Bavera PM3, Cecconi P4, Farabola M4, Mattei V2, Ambrosetti U5, Cesarani A5.
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The aim of this study was to focus on patients suffering from cochleo-vestibular disorder with and without Ménière disease (MD) in order to verify whether chronic cerebrospinal drainage abnormalities could play a role in the etiopathogenesis of endolymphatic hydrops.

Fifty-two volunteers were enrolled and subdivided into two groups: 24 definite MD and 28 not-MD. Both magnetic resonance venography imaging with contrast-enhanced imaging of the venous cerebrospinal system (MRV) and venous echo-color Doppler (ECD) were performed.

MRV showed abnormalities in 83% of MD and 57% of not-MD subjects (p < 0.001). Asymmetrical cervical venous flow, assessed by MRV, was confirmed by ECD in 62.5% of MD but in only 21.5% of not-MD subjects (p<0.001).

Chronic cerebrospinal venous insufficiency might be the anatomical background, which provides a predisposing factor for the development of endolymphatic hydrops in MD patients.

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