Dilatation of the Bridging Cerebral Veins in Multiple Sclerosis Correlates with Fatigue and Suggests an Increase in Pressure

Abstract

Abstract There is a physiological similarity between the hydrodynamics of hydrocephalus and multiple sclerosis (MS). Children with hydrocephalus have been found to have a significant enlargement of the cortical veins within the subarachnoid space, suggesting an increase in venous pressure. The purpose of this study is to discover if there is dilatation of the veins within the subarachnoid space in multiple sclerosis and to estimate the pressures required to maintain any enlargement found. 103 patients with MS were compared with a control group of 50 patients. Post contrast 3DT1 images were used. The cross-sectional area of the bridging cortical veins and the vein of Galen were measured. In MS, the superficial territory cortical veins were 29% larger and the veins of Galen were 25% larger than the controls. There is evidence of a significant increase in the bridging vein transmural pressure in MS, estimated to be approximately 6.5 mmHg in the superficial cortical veins. MS patients with significant fatigue have larger cortical veins than those who are not significantly fatigued.