This Is MS Multiple Sclerosis Community: Knowledge & Support

http://stm.sciencemag.org/content/4/147/147ra111
ABSTRACT

Because it lacks a lymphatic circulation, the brain must clear extracellular proteins by an alternative mechanism. The cerebrospinal fluid (CSF) functions as a sink for brain extracellular solutes, but it is not clear how solutes from the brain interstitium move from the parenchyma to the CSF. We demonstrate that a substantial portion of subarachnoid CSF cycles through the brain interstitial space. On the basis of in vivo two-photon imaging of small fluorescent tracers, we showed that CSF enters the parenchyma along paravascular spaces that surround penetrating arteries and that brain interstitial fluid is cleared along paravenous drainage pathways. Animals lacking the water channel aquaporin-4 (AQP4) in astrocytes exhibit slowed CSF influx through this system and a ~70% reduction in interstitial solute clearance, suggesting that the bulk fluid flow between these anatomical influx and efflux routes is supported by astrocytic water transport. Fluorescent-tagged amyloid β, a peptide thought to be pathogenic in Alzheimer’s disease, was transported along this route, and deletion of the Aqp4 gene suppressed the clearance of soluble amyloid β, suggesting that this pathway may remove amyloid β from the central nervous system. Clearance through paravenous flow may also regulate extracellular levels of proteins involved with neurodegenerative conditions, its impairment perhaps contributing to the mis-accumulation of soluble proteins.

Dr Sclafani, please feel free to provide Nigel the information regarding the locations found by Ultrasound and those identified by IVUS. Its good to hear he is now interested in IVUS, in my treatment. I remember the last time I saw him I explained to him what it was. He hadn't heard of it, at least not as IVUS. I should really set up another appointment for a scan.

From memory, I had no treatments of the Azygos. I do remember the ballooning in my Jugulars. It hurt!

hello to everyone here in the forum and in particular to Prof. Sclafani, I am new here but read you for a long time (I'm sorry my English is not so good, I'm from Germany, hope you understand me anyway).

Prof. Sclafani, as you know I'm interested in a treatment, I am plagued by uncertainties, unfortunately, that's why I could not decide yet.

Can you please tell me how high the risk of complications from a stent is (you had cases in which stents were used and it still came to restenosis?)

Then you have to take blood thinners for life?

Is it according to your experience that problems with legs, bladder, bowel are associated with Problem to the Azygosvein?

Thank you in advance for your answer.

Best Regards

Lety

A little off topic, but have you been in contact with anyone (or yourself?) performing CCSVI treatments for Lyme? This web page says that they present with 3-4 of Zamboni's criteria; compared to our measly 2.
http://betterhealthguy.com/joomla/blog/242-a-deep-look-beyond-lyme

Do you think he's likely to publish on this? I'm not familiar with who Dr. Klinghardt is.

Sake

Yes, of course, sake. I would be delighted to speak with any colleagues who are treating ccsvi. It is lonely here you know

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Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com

Stylocervical compression is something that is more apparent on MRV than on catheter venography. when i look at these narrowings with IVUS many of them seem to be phasic. In other words rotation, flexion or extension of the neck allows the vein to take on a larger diameter with better flow.

Is this a normal physiological situation? Does relieving this narrowing result in sustained clinical improvements? Do they need treatment? Tough questions with unclear answers so far.

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Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com

NIgel, since no one in the Southern Hemisphere is using a test that looks in detail at the valves, how can they be sure that these narrowings are not valves?



in my experience narrowing of the venogram is caused in decreasing order of frequency by

1. Valve immobility at least 85%
2. muscular compression
3. hypoplasia
4. septum
5. C2 bony compression
6. prior occlusion

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Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com

a courageous person, traveling alone to brooklyn, cureorbust was my first patient from the southern hemisphere. Sorry i could not achieve improvement, Cureorbust

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Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com

I found bilateral stenosis of the J1 segment of each internal jugular vein. My records show that there were immobile valves causing about 60-70% stenosis. There was also hypoplasia of the ascending lumbar vein. 18 and 20mm balloons were used requiring 13-15 atmospheres.

non-responder? perhaps. but perhaps the valves just will not stay open. perhaps surgery or stenting would have a better chance.

_________________
Salvatore JA Sclafani MD
Patient contact: ccsviliberation@gmail.com

History has shown that re-stenosis is an issue. The one thing that was disheartening was that a lot of people notice some if not amazing spontaneous improvements. My MS felt no different. And don't concern yourself / second guess, if you hyad offered stents for the Jugulars, I would of declined, for now.

I have been planning a trip for a new ultrasound, I'll send you an email with some questions I should request they take special care in checking.

I am the biggest non responder to everything. Interferons, ABX, Aimspro, Gilenya, AO ...

I thought there was someone else before me from Aus? One thing that is a clear memory, was after the procedure, the clinic staff put on the internet radio and selected Australian Hits for my benefit. A certain Australian female singer was played and Dr S let us all in a small crush he had on her. At the time I didn't know it, but by unfortunate chance, she also has MS now. And only a few months ago a TV programme they showed here a story of her travelling to Brooklyn for CCSVI treatment.

As for the Improvement, I understand we are still at the beginning of the understanding and treatment of CCSVI and its relation to MS, so there are no guarantees. It almost upset me more that I could not go home to my Neuro with some better substantiation of my "crazy" path I am investigating.

Cureorbust, I have just got off the plane from being over and seeing Paul. Did you have his CPn blood test? I did while I was there and waiting on results. I am yet to read the results from Warrens Ultrasound and I want to send it to Sal. BTW Sal Paul is very keen to talk, he is snowed under with all the work leading to this moment in time and I hope to be able to get help for his investigations. He is almost on his own with the study he is doing as well as his normal practise work. It all sounded very positive in his approach to the science of his CPn investigation. He absolutely does NOT have blinkers on BTW. He was fantastic to talk with and has his heart and mind in the right place.
Will need to get my CD of the ultrasound to Sal so some feedback can happen for Warren the Sonographer who is very particular and cautious as well!
Regards,
Nigel
Need to get 3 days worth of sleep that I missed out on!

Dr S I am not sure if I have suggested this before,
I think with the talk on CPn and Lyme and the coincidence of CCSVI that having bloods done as part of your work up, pre PTA, may be a way to confront the restenosis/vascular infections that is found in some people and also to get a balanced picture on 'issues' that may get across the BBB, due to reflux, that will need attending to in order to address the symptoms of those invaders, as well as dealing with the standard IVUS findings at PTA?
There is also the issue of some Labs consistently coming back with negatives to contend with, quote from Dr Paul Thibault;

"Why there is so much variance in Cpn serology results is probably due to sourcing of the reagents, but I haven't enquired into that at this stage."

Thoughts?

Regards
Nigel

Dr. Sclafani,
When stenting the renal vein, does the patient receive "conscious sedation" as in CCSVI procedure?
And do you enter the femoral vein?
If I recall correctly, you addressed this topic several pages back, but I can't find it.
thank you!

Cureorbust and Dr S I have forwarded to Paul Thibault the feed back!