Extracranial Venous Drainage Pattern in Multiple Sclerosis and Healthy Controls: Application of the 2011 Diagnostic Criteria for Chronic Cerebrospinal Venous Insufficiency

Chronic cerebrospinal venous insufficiency (CCSVI) has been postulated as a cause for multiple sclerosis (MS). Venous pressure assessments have not been made. Intracranial venous pressure was assessed using ophthalmodynamometry in 29 MS patients and compared with 28 healthy controls and 19 cases with elevated intracranial pressure (ICP). MS and control subjects had normal venous pressures (mean 15.5 resp. 15.1 cmHg). Only cases with intracranial pressure pathology had elevated venous pressures (mean 28.8 cmHg). There is no evidence of an increased intracranial venous pressure in MS patients.

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No association between chronic cerebrospinal venous insufficiency and pediatric-onset multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458512445943 ◽

2012 ◽

Vol 18 (12) ◽

pp. 1791-1796 ◽

Cited By ~ 13

Author(s):

MP Amato ◽

V Saia ◽

B Hakiki ◽

M Giannini ◽

L Pastò ◽

...

Keyword(s):

Multiple Sclerosis ◽

Venous Insufficiency ◽

Temporal Association ◽

Causative Role ◽

Window Of Opportunity ◽

Healthy Controls ◽

Jugular Veins ◽

Chronic Cerebrospinal Venous Insufficiency ◽

Pediatric Onset

Objective: Chronic cerebrospinal venous insufficiency (CCSVI) was hypothesized to play a causative role in multiple sclerosis (MS). The assessment of pediatric-onset MS (POMS) may provide a unique window of opportunity to study hypothesized risk factors in close temporal association with the onset of the disease. Methods: Internal jugular veins, vertebral veins and intracranial veins were evaluated with extracranial and intracranial ultrasound in 15 POMS and 16 healthy controls. Assessor’s blinding was maintained during the study. We considered subjects positive to CCSVI when at least two criteria were fulfilled. Results: CCSVI frequency was comparable between POMS and controls ( p > 0.05). Clinical features were not significantly different between CCSVI-positive and CCSVI-negative patients. Conclusions: Our findings add to previous data pointing against a causative role of CCSVI in MS.

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Internal jugular thrombosis post venoplasty for chronic cerebrospinal venous insufficiency

Phlebology The Journal of Venous Disease ◽

10.1258/phleb.2011.011052 ◽

2011 ◽

Vol 26 (6) ◽

pp. 254-256 ◽

Cited By ~ 10

Author(s):

◽

A Thapar ◽

T R A Lane ◽

V Pandey ◽

J Shalhoub ◽

...

Keyword(s):

Multiple Sclerosis ◽

Venous Insufficiency ◽

Symptom Relief ◽

Venous Drainage ◽

Chronic Cerebrospinal Venous Insufficiency ◽

Cerebral Venous Drainage ◽

Endovenous Treatment

Chronic cerebrospinal venous insufficiency (CCSVI) is a hypothesis through which cerebral venous drainage abnormalities contribute towards the pathogenesis of multiple sclerosis. CCSVI venoplasty is already practised worldwide. We report the case of a 33-year-old lady with multiple sclerosis who underwent left internal jugular venoplasty resulting in iatrogenic jugular thrombosis requiring open thrombectomy for symptom relief. This occurred without insertion of a stent and while fully anticoagulated. Clinicians should be aware that endovenous treatment of CCSVI could cause paradoxical deterioration of cerebral venous drainage. Patients with complications post venoplasty are now presenting to geographically distant vascular units.

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