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However, its clinical phenotypes and classification criteria remain poorly defined. In this single\u2010center cross\u2010sectional study, we analyzed 245 patients with CVOI using contrast\u2010enhanced CT or MR venography to identify clinical features and propose a novel anatomical classification. We identified 10 major symptoms of cerebral venous congestion, with tinnitus cerebri, neck discomfort, and tinnitus being the most common. A new classification system was proposed based on lesion location and bilateral jugular foramen narrowing rate, categorizing CVOI into intracranial (CV), extracranial (JV), and tandem (CJV) types, each further stratified into four\/five subtypes. Receiver operating characteristic (ROC) curve analysis showed that narrowing thresholds of 0.20 and 0.40 offered excellent discriminatory performance for subtype differentiation, with an area under the curve (AUC) approaching 1.0. Notably, tandem\u2010type CVOI (CJV) was the most prevalent (56.7%) and exhibited distinct symptom patterns and pathogenesis. These findings provide a practical framework for diagnosing and stratifying CVOI and may inform individualized treatment strategies.<\/jats:p>","DOI":"10.1002\/mco2.70609","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T11:12:44Z","timestamp":1772968364000},"source":"Crossref","is-referenced-by-count":1,"title":["Cerebral Venous Outflow Insufficiency: A Study on Symptoms and Venous Stenosis Classification"],"prefix":"10.1002","volume":"7","author":[{"given":"Hui","family":"Li","sequence":"first","affiliation":[{"name":"Department of Neurology Xuanwu Hospital Capital Medical University  Beijing China"},{"name":"Beijing Institute of Brain Disorders Laboratory of Brain Disorders Ministry of Science and Technology Collaborative Innovation Center for Brain Disorders, Beijing Advanced Innovation Center for Big Data\u2010based Precision Medicine, Capital Medical University  Beijing China"},{"name":"Neuro Cardio Vascular Diseases Center Xuanwu Hospital 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Brain Disorders, Beijing Advanced Innovation Center for Big Data\u2010based Precision Medicine, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenxia","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Neurology Xuanwu Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Dong","sequence":"additional","affiliation":[{"name":"Neuroscience Center Beijing Shijitan Hospital Capital Medical University  Beijing China"},{"name":"Department of Radiology Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xunming","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Neurology Xuanwu Hospital Capital Medical University  Beijing China"},{"name":"Beijing Institute of Brain Disorders Laboratory of Brain Disorders Ministry of Science 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