Chronic Cerebrospinal Venous Insufficiency and Multiple Sclerosis

Bagert, Bridget; Marder, Ellen; Stüve, Olaf

doi:10.1001/archneurol.2011.179

Cited by 21 publications

(16 citation statements)

References 28 publications

(19 reference statements)

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“…However, this would need to be due to an increase in venous pressure rather than a decrease in ICP. The notion that there is an elevation in venous pressure in MS has been extensively investigated, reviewed and disputed [18–20]. Therefore the cause for the dilatation is undefined and awaits further study.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the sagittal sinus cross-sectional area between patients with multiple sclerosis, hydrocephalus, intracranial hypertension and spontaneous intracranial hypotension: a surrogate marker of venous transmural pressure?

Bateman

Lechner‐Scott

Copping

et al. 2017

Fluids Barriers CNS

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There is evidence that patients with multiple sclerosis (MS) and hydrocephalus share some common pathophysiological mechanisms. Alterations in CSF pressure are known to affect cerebral venous sinus geometry. To further explore these mechanisms, we measured the superior sagittal sinus (SSS) cross-sectional area 3 cm above the torcular using T2 images in 20 MS, 10 spontaneous intracranial hypotension (SIH), 21 hydrocephalus and 20 idiopathic intracranial hypertension (IIH) patients and compared with 20 matched controls. The SSS area was reduced by 25% in hydrocephalus (p = 0.0008), increased by 22% (p = 0.037) in SIH and unchanged in IIH compared to matched controls. In MS there was a 16% increase in SSS area (p = 0.01).The findings suggest that changes in SSS cross-sectional are common between MS and SIH patients, while in hydrocephalus and IIH these are different.Electronic supplementary materialThe online version of this article (doi:10.1186/s12987-017-0066-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Comparison of the sagittal sinus cross-sectional area between patients with multiple sclerosis, hydrocephalus, intracranial hypertension and spontaneous intracranial hypotension: a surrogate marker of venous transmural pressure?

Bateman

Lechner‐Scott

Copping

et al. 2017

Fluids Barriers CNS

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“…The major amount of knowledge regarding MS points toward immune etiopathogenesis [202]. A number of recent studies examined a cause-and-effect relationship between MS and CCSVI by applying the so-called Bradford Hill criteria [4,52,203]. The Bradford Hill criteria examines the strength of the association, the consistency, the specificity, the temporality, the biological gradient and plausibility, the coherence, the experiment and the analogy between the two phenomena [204].…”

Section: Associated Central Nervous System Disorders and Agingmentioning

confidence: 99%

Potential involvement of the extracranial venous system in central nervous system disorders and aging

Zivadinov

Chung

2013

BMC Med

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BackgroundThe role of the extracranial venous system in the pathology of central nervous system (CNS) disorders and aging is largely unknown. It is acknowledged that the development of the venous system is subject to many variations and that these variations do not necessarily represent pathological findings. The idea has been changing with regards to the extracranial venous system.DiscussionA range of extracranial venous abnormalities have recently been reported, which could be classified as structural/morphological, hemodynamic/functional and those determined only by the composite criteria and use of multimodal imaging. The presence of these abnormalities usually disrupts normal blood flow and is associated with the development of prominent collateral circulation. The etiology of these abnormalities may be related to embryologic developmental arrest, aging or other comorbidities. Several CNS disorders have been linked to the presence and severity of jugular venous reflux. Another composite criteria-based vascular condition named chronic cerebrospinal venous insufficiency (CCSVI) was recently introduced. CCSVI is characterized by abnormalities of the main extracranial cerebrospinal venous outflow routes that may interfere with normal venous outflow.SummaryAdditional research is needed to better define the role of the extracranial venous system in relation to CNS disorders and aging. The use of endovascular treatment for the correction of these extracranial venous abnormalities should be discouraged, until potential benefit is demonstrated in properly-designed, blinded, randomized and controlled clinical trials.Please see related editorial: http://www.biomedcentral.com/1741-7015/11/259.

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“…In the same study, none of the healthy controls fulfilled the criteria for CCSVI diagnosis [6] . However, different subsequent studies examining CCSVI prevalence in MS were unable to confirm Zamboni's 2009 findings [9,10] .…”

Section: Introductionmentioning

confidence: 87%

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

et al. 2016

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The etiology of multiple sclerosis (MS) is still largely unknown and it has been proposed that an impaired venous drainage from the central nervous system, defined as chronic cerebrospinal venous insufficiency (CCSVI), may play a role in this. We investigated the prevalence of extracranial venous drainage pattern alterations in a cohort of MS patients based on the 2011 revised diagnostic criteria for CCSVI. Thirty-nine MS patients and 18 healthy subjects underwent blinded extra-cranial venous echo-color Doppler sonography to reveal the presence of CCSVI. There was no statistically significant difference between MS patients and healthy controls regarding CCSVI prevalence (p value = 0.53). The results challenge the hypothesis that CCSVI plays a primary role in the pathogenesis of MS.

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Chronic Cerebrospinal Venous Insufficiency and Multiple Sclerosis

Cited by 21 publications

References 28 publications

Comparison of the sagittal sinus cross-sectional area between patients with multiple sclerosis, hydrocephalus, intracranial hypertension and spontaneous intracranial hypotension: a surrogate marker of venous transmural pressure?

Comparison of the sagittal sinus cross-sectional area between patients with multiple sclerosis, hydrocephalus, intracranial hypertension and spontaneous intracranial hypotension: a surrogate marker of venous transmural pressure?

Potential involvement of the extracranial venous system in central nervous system disorders and aging

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

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