Endovascular intervention for obstruction to venous drainage of the head and 
neck is an established treatment for disorders such as superior vena cava 
syndrome. Some patients with multiple sclerosis have been observed to have 
anomalies of the veins draining the head and neck. It is possible that some 
symptoms associated with multiple sclerosis may be secondary to disturbed venous 
flow. In an uncontrolled clinical series of 40 patients who had been previously 
diagnosed with multiple sclerosis, anomalies of the venous drainage of the head 
and neck were observed, including venous stenoses of the internal jugular veins. 
In 38 of 40 patients, venous stents were placed with restoration of luminal 
dimensions and abrogation of the venous pressure gradient. The angiographic and 
hemodynamic improvement was associated with improvement in symptomatology, most 
particularly in cognitive and constitutional symptoms that may be related to 
cerebrovenous flow. Serious complications included death in one subject and 
stent embolization requiring open heart surgery in another. In conclusion, in 
this series, endovascular intervention to correct venous stenosis associated 
with multiple sclerosis was associated with improvement in symptoms possibly 
related to disturbed venous hemodynamics. However, given the serious adverse 
events in this small series, a randomized clinical trial is required to confirm 
these findings, and to determine if the procedure has any effect on the 
progression of multiple sclerosis, or untoward long-term adverse effects.