DrSclafani answers some questions

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Re: DrSclafani answers some questions

Postby David1949 » Wed Sep 07, 2011 8:55 pm

Dr. Sclafani it is reported that about 20% of people in the general population do not have valves in the jugular veins. Could you estimate what that percentage would be among the people you've treated for CCSVI?
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Postby Cece » Thu Sep 08, 2011 6:02 am

cheerleader wrote:Found some interesting research on condylar differences in 50 normals, as shown on CT scan. It seems that in normals, there is asymetry or ageneis in the condylar veins, but not these giant veins like you're seeing in pwMS, and the occipital bone showed differences which affected the veins...
In all cases, the anterior condylar veins connected the anterior condylar confluence to the marginal sinus; however, a number of cases with asymmetry and agenesis in the posterior and lateral condylar veins were seen. The posterior condylar vein connected the suboccipital cavernous sinus to the sigmoid sinus or anterior condylar confluence. The posterior condylar canal in the occipital bone showed some differences, which were accompanied by variations in the posterior condylar veins. In conclusion, there are some anatomical variations in the venous structures of the craniocervical junction; knowledge of these differences is important for the diagnosis and treatment of skull base diseases. Contrast-enhanced CT using a multidetector scanner is useful for evaluating venous structures in the craniocervical junction.

http://bjr.birjournals.org/cgi/content/ ... 83/994/831

Dr. Z found that the condylar system became one of the main collateral pathways activated in CCSVI. In fact, that's exactly what my hubby had. No jugulars, but big, squirrely condylars. Once he had jugular veins open and flowing, the condylars disappeared. Since his blockage was high, into transverse sinus, maybe that's why the condylars became developed? Maybe it has to do with the location of stenotic lesion and availability of collateral drainage at that location....the old freeway detour analogy?
The main collateral pathways activated in the course of CCSVI are the condylar venous system, the pterygoid plexus and the thyroid veins.2,6 Additionally, the suboccipital cavernous sinus and the hemiazygous-lumbar venous anastomosis with the left renal vein may also become prominent substitute circles. Collateral circulation prevents brain oedema and intracranial hypertension,2,4 and ensures a correct but slower, and thus insufficient, venous drainage.12,14

http://phleb.rsmjournals.com/content/25/6/269.full
anyway, just read that you may still be on vacation...in which case, nevermind, and we'll all catch up with you later....
cheer

It's good to hear that his condylars diminished in size after the jugulars were treated.
Great research.

As for location, I had the enlargened condylars and my stenoses were valvular, which is quite far away.
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Re: DrSclafani answers some questions

Postby Cece » Thu Sep 08, 2011 6:18 am

David1949 wrote:Dr. Sclafani it is reported that about 20% of people in the general population do not have valves in the jugular veins. Could you estimate what that percentage would be among the people you've treated for CCSVI?

www.thisisms.com/forum/post173774.html#p173774

He didn't give an estimate before but said that normal healthy valves are almost impossible to see.
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Re: DrSclafani answers some questions

Postby bluesky63 » Thu Sep 08, 2011 5:12 pm

Greetings. I don't know if this is an area that relates or not, but here goes. Without the entire back story, I was told today by a gynecologist that I am being referred to the local IR for enlarged and prominent pelvic veins (detected on an ultrasound done for other reasons). I was surprised -- I've been in a lot of pain and assumed it was something ovarian, but apparently my ovaries look fine. I am wondering if you have any knowledge of "prominent pelvic veins" and "pelvic congestion" and if this would overlap in any way with the veins typically assessed for CCSVI.

The doctor I saw today said that it's common to use sclerotherapy to "seal off" tortuous veins like this in the pelvis. This made me wonder, what happens to people who have this done? Is there an impact on the rest of the venous system in the nearby anatomy? On potential neuro symptoms?

Thank you very much for any information.
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Re: DrSclafani answers some questions

Postby NHE » Thu Sep 08, 2011 10:41 pm

bluesky63 wrote:The doctor I saw today said that it's common to use sclerotherapy to "seal off" tortuous veins like this in the pelvis. This made me wonder, what happens to people who have this done? Is there an impact on the rest of the venous system in the nearby anatomy? On potential neuro symptoms?

Thank you very much for any information.


While I don't know if it's the exact same thing, it sounds very similar to a treatment my father had for a varicose leg vein. I believe that there was a compound injected into the vein that was supposed to make the vein die off. This was a disaster. The treatment caused tissue necrosis and he essentially had a hole in the side of his leg. He had to go to a wound healing clinic in order to get some help so it would heal over.

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Re: DrSclafani answers some questions

Postby Cece » Fri Sep 09, 2011 6:33 am

Bluesky, I hope you find some relief from that pain. We might not hear from Dr. Sclafani for quite some time as he is away on a two-week vacation!

The concern is, if the pelvic veins are sealed off, where would any flow reroute?
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Re: DrSclafani answers some questions

Postby bluesky63 » Fri Sep 09, 2011 6:55 am

Ah, I didn't realize about the vacation. I hope he is having a wonderful time. :-) Thanks for the replies. I am horrified by what happened to your father, my dear NHE! And I am baffled by the conflicting issues here -- open up a vein? seal off a vein? stenosed veins? dilated veins? And I'm jittery anyway because of the aneurysms in my family. Hence the desire for actual knowledge and experience. But maybe it's all new. It looks like I'll see the IR before Dr. S is back on board. And on we go . . .
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Re: DrSclafani answers some questions

Postby Cece » Fri Sep 09, 2011 7:41 am

http://lucy.stanford.edu/circulation.html

I looked this up and it may be worth consulting with a CCSVI IR before you take action.

Description: The pelvic circulation for the sigmoid colon and rectum is derived by the inferior mesenteric a. from the aorta, and the remaining viscera derive blood flow via the common iliac a., except for the ovarian a. which are from the abdominal aorta. The external iliac a. separates from the internal iliac a. just above the pelvic inlet, and courses anteriorly into the lower extremity by passing beneath the inguinal ligament. At the level of division of the external a., the internal iliac a. has three branches, the iliolumbar a., the lateral sacral a., and the large superior gluteal a. , the latter exiting above the piriformis m. Distally, at the lower margin of the piriformis m., seven major branches are visible anteriorly in the pelvis: the obturator a., superior vesical a., the uterine a., the inferior vesical a., the middle rectal a., the internal pudendal a., and the inferior gluteal a. Posteriorly, the inferior rectal a. branches from the internal pudendal a. supply the anal canal. The venous collecting system in the visceral pelvis, in contrast to most other regions, begins from plexuses about the bladder, ovary, uterus and cervix, and the anorectal region. These tributaries coalesce into identifiable, although variable veins. As with the a., the ovarian vein courses laterally through the suspensory ligamant of the ovary, draining directly into the vena cava on the right, and into the renal v. in the left. Distally, the larger of the venous plexus are the inferior mesenteric v., draining to the portal v., and the middle and inferior rectal v. These drain to the internal pudendal v. which courses cephalad, connecting with the inferior gluteal v. and the lateral sacral v. to form the internal iliac v. This v. joins the external iliac v. at the pelvic inlet forming the common iliac v.. In the perineum, the internal pudendal v. collects blood from the bulbospongiosis m., the bulb of the vestibule and greater vestibular gland, the superficial transverse perineal m., the levator ani m., and the external anal sphincter. During pregnancy, the normally tortuous uterine vessels become elongated and enlarged to meet the new metabolic demands.

Were you ever checked for renal stenosis or May Thurner?
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Re: DrSclafani answers some questions

Postby bluesky63 » Fri Sep 09, 2011 3:13 pm

Wow, Cece, that's a lot of info packed into that paragraph! :-) I think I may have been checked for MT bbut definitely not for renal. I feel like I'm in nauseating labor with a bonus of chronic appendicitis and cement legs. Yuck. Looking forward to figuring it out, whatever the cause.
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Re: DrSclafani answers some questions

Postby Cece » Sat Sep 10, 2011 4:17 pm

Having been in nauseating labor myself, yikes, I sympathize....

The IR who does your pelvic vein treatment should be able to answer the question of where the blood flow will reroute. The concern would be if it reroutes to the renal vein (if you also have a renal stenosis) or the ascending lumbars or anything that leads to the azygous. I think.

A question for Dr. Sclafani, that he might not find and that I might forget, is this:
Dr. Gilhooly has said the following. The latter part (that over-agressive high pressure ballooning may risk venous damage) is easily agreed with, although over-aggressive ballooning needs to be well defined. But what about the first part? It is not possible to permanently disrupt these valves using balloons?
It is thought that permanent disruption of the valves using balloons alone is not possible at present and that over aggressive high pressure ballooning may risk venous damage.

chronic-cerebrospinal-venous-insufficiency-ccsvi-f40/topic17810.html#p175517
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Re: DrSclafani answers some questions

Postby Taurus » Mon Sep 12, 2011 2:38 am

Dear Sir
Thank you very much for helping MS patients like me on this forum. Diagnosed with MS in December 2008, I got my MRV done at a local hospital. My MRI pics are posted at http://liberation-treatment.com/ms-patient-mrv-scans. My CT venogram also suggested of stenosis at C2 level But my IR disclosed that I have a rare case of Eagle Syndrome. With all this in back ground, I went for liberation treatment which resulted in small improvements as the doc said that he did not find high level of stenosis in IJVs while azygos was clear. Still, I find that my MS has to do something with hemodynamics as often experience heavy sweating from my head once I go on the treadmill. My spasticity in right arm changes with posture (sitting vs standing ) etc. May my IR has left something while doing the procedure or I need to check something else also. I have no typical symptoms of Eagle Syndrome except that lately I sometime felt dizzy one I turned my head towards right. Your expert opinion is solicited please.
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Re: DrSclafani answers some questions

Postby Cece » Sat Sep 17, 2011 8:03 pm

*bump*
:)
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Re: DrSclafani answers some questions

Postby pelopidas » Sun Sep 18, 2011 10:06 pm

OVER 400.000 VIEWS?

Congratulations!
i wish there were over 400.000 people liberated, too!

:YMHUG:
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Re: DrSclafani answers some questions

Postby deezll » Mon Sep 19, 2011 3:10 am

hi Dr S, I just had an appointment with a prof. vascular/brain surgeon at my local hosp. who brought me in to say 'I've looked at your CT scans and there's nothing wrong with your veins.'
What do i do?
Glasgow folk said the same after an ultrasound last year.
Do i drop it and assume i'm one of the 3% of MSers who have totally unaffected blood flow (even though O2 therapy seems to give albeit shortlived benefit) or do i get a copy of the scans and send them to you/someone who knows about CCSVI?
the more i read about ccsvi the more it seems that looking at blood tubes inside the body is an art not a science but how many and whose opinions do i listen to/politely ignore?
(hope i put this in the right place)
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Re: DrSclafani answers some questions

Postby Taurus » Mon Sep 19, 2011 8:35 am

Please get your arteries like Internal Carotid (both) and others also checked through MRA. I am not a doc but strongly feels CCSVI or insufficient inflow are the reasons behind MS mystery.
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