Italian Chronic Cerebrospinal Venous Insufficiency National Epidemiological Observatory methodology and preliminary data

Abstract

The aim of our work is to describe the Memnet program’s use and potential and to show the data of Italian Chronic Cerebrospinal Venous Insufficiency (CCSVI)-National Epidemiological Observatory (NEO) activity in the first three years (http://www.osservatorioccsvi. org). From 2011 to 2014, all echo-color- Doppler (ECD) assessments were stored by Mem-net program into CCSVI-NEO web site (http://www.mem-net.it). Mem-net is a tool for multicenter data collection based on the International Society for Neurovascular Disease consensus and position statement, where we can insert patients (pts) history, neurological visits, ECD assessments, different examinations, therapies and surgical procedures. The website provides an epidemiological and statistical program for data analysis in real time. At present, 7 medical centers, affiliated to CCSVI-NEO, input their symptomatic and asymptomatic subjects with CCSVI. Data were storage using the Mem-net program. We analyzed data of only four centers on seven (Rome, Bari, Cagliari and Benevento). Total pts number with multiple sclerosis (MS) was 1109, mean age 46.0±13.4 [male 422 (38.05%); female 687 (61.95%)]. CCSVI positive pts were 937 (84.49%), CCSVI negative pts were 172 (15.51%). The CCSVI type 1 subjects were 530 (56.56%), CCSVI type 2 subjects were 20 (2.13%), CCSVI type 3 subjects were 387 (41.30%). We found 800 (85.38%) pts with criterion 1; 725 (77.37%) with criterion 2; 519 (55.39%) with criterion 3; 483 (51.55%) with criterion 4; 88 (9.39%) with criterion 5. The venous hemodynamic insufficiency severity score mean score was 3.8; the CCSVI mean score was 2.8; the MEM mean score was 34.7; the expanded disability status scale mean score was 4.5; the disease mean duration was 12.5±5.7 years. MS clinical types were divided as follows: relapsing-remitting pts were 449 (47.92%), Secondary progressive pts were 144 (15.37%), primary progressive pts were 72 (7.68%). The CCSVI-NEO database and Memnet software may be useful medical and researching tools for recording, storing, analyzing and studying ECD and vascular data. Preliminary data of NEO show an elevated prevalence of CCSVI in MS.

Analysis of patients with chronic cerebro-spinal venous insufficiency and multiple sclerosis: identification of parameters of clinical severity

“…23 Similar results were quite recently described by an active multicenter epidemiological registry. 24 Therefore, our results replicate those coming from developed international scientific literature about this topic, as well as from several confirming metaanalysis. 25 Recently it was also shown that diagnostic procedure by ECD is reproducible between different operators from the technical perspective.…”

Jugular valve function and petrosal sinuses pressure: a computational model applied to sudden sensorineural hearing loss

“…The curves comparing SPS/IPS pressure in patients and control (Figure 1) clearly show the raise in venous pressure, at the intracranial level, of patients exhibiting absence of Doppler detectable flow through the defective valve. 2,3,23,24,31,32 The four patients presented some abnormalities in cerebral venous return, mainly focused on IJV valve function. The valve leaflets motility were M-mode investigated together with spectral-flow characteristics, 23 demonstrating how the presence of a defective valve opening determines also abnormal haemodynamics.…”