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

2012 ◽  
Vol 18 (12) ◽  
pp. 1791-1796 ◽  
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.

Intracranial venous pressure is normal in patients with multiple sclerosis

2011 ◽  
Vol 17 (5) ◽  
pp. 637-638 ◽  
Author(s):  
Rolf Meyer-Schwickerath ◽  
Christian Haug ◽  
Annette Hacker ◽  
Frauke Fink ◽  
Dietmar Seidel ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Intracranial Pressure ◽  
Venous Insufficiency ◽  
Venous Pressure ◽  
Healthy Controls ◽  
Elevated Intracranial Pressure ◽  
Control Subjects ◽  
Chronic Cerebrospinal Venous Insufficiency ◽  
Icp Ms ◽  
And Control

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.

Chronic cerebrospinal venous insufficiency: does ultrasound really distinguish multiple sclerosis subjects from healthy controls?

2011 ◽  
Vol 22 (5) ◽  
pp. 970-979 ◽  
Author(s):  
Fatih Kantarci ◽  
Sait Albayram ◽  
Nuri Onat Demirci ◽  
Asim Esenkaya ◽  
Derya Uluduz ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Venous Insufficiency ◽  
Healthy Controls ◽  
Chronic Cerebrospinal Venous Insufficiency

scholarly journals The role of magnetic resonance imaging in assessing venous vascular abnormalities in the head and neck: a demonstration of cerebrospinal venous insufficiency in a subset of multiple sclerosis patients

2015 ◽  
Vol 4 (2) ◽  
Author(s):  
E. Mark Haacke ◽  
Sean K. Sethi ◽  
Jing Jiang ◽  
Ying Wang ◽  
David T. Utriainen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Data Acquisition ◽  
Venous Insufficiency ◽  
Healthy Controls ◽  
Resonance Imaging ◽  
Jugular Veins ◽  
Vascular Abnormalities ◽  
Multiple Sclerosis Patients

The study of chronic cerebrospinal venous insufficiency (CCSVI) and its impact on the development and progression of multiple sclerosis (MS) remains controversial. Although the initial thrust in evaluating CCSVI was with ultrasound, other modalities including magnetic resonance imaging (MRI) have been used to study venous vascular abnormalities. This review focuses on the findings of a number of past MRI studies including a look at a combined study of four previous works with a cohort of 559 MS patients regarding structure and function of the extra-cranial vasculature. Strengths and limitations of each paper are discussed which give insight into conflicting reports of venous abnormalities in MS patients and healthy controls. Guidelines for data acquisition and analysis for future studies related to extra-cranial structure and flow, both arterial and venous, are discussed. This includes the grading of stenosis of the internal jugular veins (IJVs) as well as normalized flows through major veins of the neck. The lack of agreement between most studies is likely due to inconsistent data acquisition and incomplete data analysis. Our own work over four independent sites shows good agreement, indicating that there is a high incidence of stenosis and structural venous abnormalities in the MS population and that this change results in reduced outflow of the IJVs and increased collateralization of venous return to the heart compared to healthy controls.

scholarly journals Social Media Representation of Chronic Cerebrospinal Venous Insufficiency Intervention for Multiple Sclerosis

2016 ◽  
Vol 18 (2) ◽  
pp. 49-57 ◽  
Author(s):  
Setareh Ghahari ◽  
Susan J. Forwell
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Social Media ◽  
Health Care Professionals ◽  
Venous Insufficiency ◽  
Scientific Evidence ◽  
Chronic Cerebrospinal Venous Insufficiency ◽  
Before And After ◽  
Social Persuasion

Background: We conducted a rigorous review of videos related to multiple sclerosis (MS) and chronic cerebrospinal venous insufficiency (CCSVI) treatment posted by people with MS on one social media website (YouTube) that describe symptoms before and after the surgical procedure, as well as videos presented by health-care professionals (HCPs). Methods: All relevant videos posted from December 2009 to July 2011 were downloaded, viewed, and systematically organized. Categorical data were classified, and dominant messages were gleaned. Results: A total of 1789 videos were extracted. A total of 621 videos by people with MS and 238 by HCPs were included. Eighty-six percent of people with MS anecdotally reported experiencing some improvement in at least one symptom. The most common message was that “CCSVI is not a miracle but worth trying.” Most HCPs posting videos recommended the procedure but called for continued research. Conclusions: Social media are conveying an anecdotal favorable message about CCSVI treatment for MS. The relative absence of videos offering a negative or more balanced perspective is a concern. Social persuasion through these videos creates a strong positive impression of CCSVI treatment, but the videos do not acknowledge the lack of supporting scientific evidence and the possible role of the placebo effect. Given the strong influence of social media on health-care decision making, researchers and clinicians should actively use social media to reach out to people with MS and describe the state of the evidence for MS treatments, both positive and negative.

The Hypothesis of Pathophysiological Correlation between Chronic Cerebrospinal Venous Insufficiency and Multiple Sclerosis: Rationale of Treatment

2012 ◽  
Vol 27 (1_suppl) ◽  
pp. 178-186 ◽  
Author(s):  
M Lugli ◽  
M Morelli ◽  
S Guerzoni ◽  
O Maleti
Keyword(s):  
Multiple Sclerosis ◽  
Intravascular Ultrasound ◽  
Venous Insufficiency ◽  
Ultrasound Examination ◽  
Strong Association ◽  
Venous System ◽  
Chronic Cerebrospinal Venous Insufficiency ◽  
Ultrasound Findings ◽  
Ultrasound Assessment

Background: The possible role of the venous system in the pathogenesis of chronic neurodegenerative diseases has been hypothesized for decades. Quite recently, the description of a venous condition defined as chronic cerebrospinal venous insufficiency (CCSVI) and its strong association with multiple sclerosis (MS) has brought back the attention of the scientific community to the hypothesis of an aetiological or concomitant role of an altered venous function in the occurrence of this pathology. CCSVI is identified by sonographic criteria, thus the indication for its possible treatment is based on ultrasound findings. Method: We retrospectively examined 167 consecutive patients affected by clinically defined MS and CCSVI, identified by ultrasound assessment by the presence of at least two sonographic criteria. Ultrasonographic diagnosis of CCSVI was then integrated by venography and intravascular ultrasound examination (in 43 patients). Patients were all submitted to endovascular procedure (venoplasty). Results In 37% of cases there was no correspondence between the preoperative ultrasound assessment and the venographic findings. In the event of incongruity between venography and sonography, the intravascular ultrasound examination investigation, when performed, confirmed ultrasound findings in 42% of cases and venography results in 58%. At one month in 12% of cases ultrasound assessment showed the persistence of altered flux. In 67% of cases patients reported subjective amelioration, regarding non-specific symptoms. Conclusion: The pathophysiology of CCSVI is yet to be defined. The superior cava venous system is highly complex in terms of anatomy and possible anomalies, as well as its haemodynamic mechanisms. Further studies are required to define the parameters of diagnosis and treatment of CCSVI.

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