drsclafani wrote:
All i see at that link is a single image of an MRvenogram. It does not show much of interest and does not visualize the more essential area where most of the stenoses occur
so it is not possible for me to advise you since i do not have sufficient informoation to help you. Neither the clinical information that would help me decide whether you should proceed to the next step. I generally do not use MRV to decide whether to perform venography. Of course, there are signs on MRVenograms that can point to ccsvi, but in your case the single image was insufficient.
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Cece wrote:Off the marc?drsclafani wrote:I do not think that reflux up the jugular vein is really the pathophysiology of this entity. Dr. Zamboni suggests that it the obstruction that is the real problem. This leading to reversal of flow through small vessels not designed to take that kind of flow. I do not think the problem is pressure or reverse pressure. it is flow
http://www.thisisms.com/ftopicp-98309.html#98309
Not sure I understand that, but it seemed relevant. Does a vein pinched by a muscle still grow collaterals?
Zamboni's Five Criteria - two must be present for a CCSVI diagnosis:
1. Reflux in the IJVs and/or VVs in sitting and supine posture;
2. Reflux in the DCVs;
3. High-resolution B-mode evidence of IJV stenoses;
4. Flow not Doppler-detectable in the IJVs and/or VVs;
5. Reverted postural control of the main cerebral venous outflow pathways.
marcstck wrote:I misstated in my previous post. I should have said most IRS are treating every stenosis they see, not stenting. There is definitely a lot more ballooning than stenting going on. I'll actually go back and change that through the edit function now.
Cece wrote:I would think another way for CCSVI to do damage without causing reflux is if the obstructions slow down the flow of blood, reducing the cerebral perfusion of the brain, which is known in MS to be reduced.
To demolish my earlier point, if an obstruction is low enough down, leaky walls in the collateral or near the obstruction shouldn't matter much, since it wouldn't be leaking onto brain tissue. Hmm.
A question of my own: in CCSVI, why might a jugular have an abnormally high flow velocity?
Cece wrote:I would think another way for CCSVI to do damage without causing reflux is if the obstructions slow down the flow of blood, reducing the cerebral perfusion of the brain, which is known in MS to be reduced.
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