Hi@,
the topic isn’t really easy for a medical layperson. I will try to write down in plain terms how I did understand Dr. Schelling’s explanation of Rici’s problem.
Arne (not a native English speaker)
p.s. Dr Schelling writes sometimes in our csvi-ms.net forum - beautiful mind.
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If the MRI proves emanating "Dawson fingers" or "Steiner-splashes" from the cerebral chamber - the damaged area has been targeted of pressure bumps which have been reached from the neck veins.
This can happens if the neck veins are compressed without the possibility that their content of blood can avoid fast enough towards the heart where a jugular stenosis often plays a critical role.
If the valves of the internal V. jugularis don’t close properly, under "certain circumstances" it may be possible that on the right site it’s particularly easy that the venous blood is floating up from the body to the brain - and there is where the venous brain damage takes place.
But unfortunately this "certain circumstances” at each CCSVI in MS are still far of a clear determinability.
A jugular and/or azygous stenosis preferential venous reflux along the affected venous paths. To “cure” MS with the "liberation treatment" can be more expected if the “Dawson fingers” and “Steiner-splashes” are limited on the (Dawson fingers & Steiner-splashes) associated venous stenosis.
Every dilatation of a vein puts risks on the vein valve which is unfortunately inevitable if a stent is going to be inserted. Until now there has been no follow-up of MS patients reported. So the risk of valve damage is therefore still unknown.
But if the destroyed jugularis valve isn’t located on a drainage path of the internal cerebral veins - or because of a valve insufficiency of all tributaries of the right heart site the venous reflux from the thorax is evenly distributed – there is no venous brain damage to be expected either.