No cerebrocervical venous congestion in patients with multiple sclerosis

@article{Doepp2010NoCV,
  title={No cerebrocervical venous congestion in patients with multiple sclerosis},
  author={Florian Doepp and Friedemann Paul and Jos{\'e} Manuel Valdueza and Klaus Schmierer and Stephan Schreiber},
  journal={Annals of Neurology},
  year={2010},
  volume={68}
}
Multiple sclerosis (MS) is characterized by demyelination centered around cerebral veins. Recent studies suggested this topographic pattern may be caused by venous congestion, a condition termed chronic cerebrospinal venous insufficiency (CCSVI). Published sonographic criteria of CCSVI include reflux in the deep cerebral veins and/or the internal jugular and vertebral veins (IJVs and VVs), stenosis of the IJVs, missing flow in IJVs and VVs, and inverse postural response of the cerebral venous… 
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Assessment of the prevalence of CCSVI in Danish MS patients using sonography and comparing these findings with MRI measures of venous flow and morphology finds that the disease is more likely to be an autoimmune disease than a vascular disease.
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Transcranial sonography reveals brain parenchyma hyperechogenic alterations (BPHA) that are thought to reflect iron accumulation, and potential association of BPHA with chronic cerebrospinal venous insufficiency (CCSVI) in MS is investigated.
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  • Medicine, Psychology
    Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques
  • 2015
TLDR
Five venous characteristics were recommended to evaluate CCSVI: criterion 1 evaluates extracranial reflux in the internal jugular or vertebral veins in sitting and supine positions, and criterion 5 assesses reverted postural control of the main cerebral venous outflow pathway.
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In patients with multiple sclerosis (MS), Zamboni et al[1][1] described anomalies of venous outflow at color Doppler high-resolution examination and multiple severe extracranial stenosis at
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TLDR
There is an urgent need to define and validate the spectrum of cranial/extracranial venous anomalies and to establish reliable, diagnostic gold-standard test(s) for CCSVI.
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TLDR
The proposed association between CCSVI and MS is described, the current data are summarized, the role of endovascular therapy is discussed, and the need for rigorous randomized clinical trials to evaluate this association and treatment is discussed.
No evidence of chronic cerebrospinal venous insufficiency at multiple sclerosis onset
TLDR
This hypothesis that chronic cerebrospinal venous drainage is the possible cause of multiple sclerosis is investigated by studying the occurrence of CCSVI in clinically isolated syndromes (CISs) suggestive of MS.
Extra-cranial venous flow in patients with multiple sclerosis
[No support for the hypothesis of chronic cerebrospinal venous insufficiency in multiple sclerosis].
TLDR
Evaluating the jugular veins using duplex sonography in patients with multiple sclerosis found that vascular intervention in MS is not recommended and IJV changes that meet the CCSVI criteria have not been found.
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