drsclafani wrote:
I have been involved with this since 2009 and no one has ever mentioned the emissary veins. No one!
drsclafani wrote:
since i have begun starting all procedures from the transverse sinuses, i have noted three patterns in patients with ccsvi
Do you know of any other IRs who start procedures in the transverse sinus?
Is there anything else being overlooked that you can think of?
What comes to mind is that IRs are such do-ers, that if a vein is too small to be treated, it is unimportant. Lumbar veins, vertebral veins, emissary veins.... But you need to know these veins in order to know CCSVI. It reminds me too of the ISET presentation on MS and that IRs treating CCSVI need to understand MS, even if it is not directly applicable to the 'do-ing' of what you do (balloons etc.) You can't see connections if you don't look at the full picture.
Quote:
1. enormous condylar veins draining into the posterior neck muscles and the vertebral veins
2. completely nonvisualized condylar veins
3. small condylar veins
I have never seen a condylar vein drain into the brain
I can make no correlations yet with heat intolerance since almost all patients have heat intolerance.
I havent made any correlation with spinal lesions. either.
Trying to understand why some patients have very large and others have very small condylar and other emissary veins is perplexing.
But typically it is either very large or very small or nonvisualized? Is there a known 'normal' size in between and you are not seeing normal?
We are endlessly interesting patients.
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perhaps prenatal jugular malformations result in large emissary canals.
perhaps jugular stenoses developing after skull development inhibits enlargement of bony canals. I find it implausible that emissary canals would enlarge much later in life.
Thanks for the links
I can look this up too but when is the window for skull development and when these bony canals could theoretically enlarge? Largest growth up to age 2 and smaller growth from then on until adolescence?
Is there any difference in size of emissary veins in warm climates vs cold climates? If they are pivotal in heat management, are they typically larger in warm climates.
If enlargened emissary veins add to the flow through the cervical spinal circulation, this would impair the drainage through the small veins that directly drain the cervical spine. Or would the veins just grow bigger, particularly if this is all present prenatally, and be able to compensate for this.
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Both Dr. S and you were part of the absentees on here. Then some people who frequent this board must have seen the new board and thought, "I must be on the wrong forum." 
