This will be long, but I hope it will explain a bit more about why Dr. Brandes is saying what he is at this time.
In his essay, Dr. Brandes likens CCSVI to what he has seen in congestive heart failure. Here's what happens in congestive heart failure-
As the heart's pumping action is lost, blood may back up in other areas of the body, producing congestion in the lungs, the liver, the gastrointestinal tract, and the arms and legs. As a result, there is a lack of oxygen and nutrition to organs, which damages them and reduces their ability to work properly.
Congestion- is an abnormal accumulation of blood that occurs due to stenosis of veins, thrombosis of veins, or failure of an organ to drain properly. It creates a lack of oxygen.
Let's work with that word, "congestion" We know about venous congestion in other parts of the body:
Venous congestion occurs-
In the liver, is called Budd Chiari--caused by an occlusion or stenosis of the hepatic veins
In the spleen- is called Chagas' Disease
In the heart is called Pulminary Venous Congestion
All over the body is called Systemic Venous Congestion
What about the brain? What do we know about venous congestion in the brain?
We know about intracranial
(meaning inside the brain) venous congestion which can happen due to dural arteriovenous malformations. This means the veins inside the brain become blocked, and edema, bleeding and brain damage can occur.http://www.ajnr.org/cgi/content/abstract/15/8/1501
Neuroradiologists know all about venous congestion due to venous blockage inside the brain.
But what about extracranial
venous outflow creating congestion? Believe it, or not...this area of the body has not been studied with as much focus as other parts. Why? Dr. Dake explained it to me and Jeff this way:
The neuroradiologists look inside the brain, the cardio-thoracic radiologists look at the heart and chest. No one has studied the neck.
So, extracranial venous outflow has been neglected. It has been studied in relation to intracranial hypertension:
Here's a study from 2005-http://www.springerlink.com/content/r28484t2127691qx/
To our knowledge, the extracranial venous drainage was not systematically evaluated in these patients. This study compared extracranial cerebral venous outflow in eight IIH patients and eight control subjects using magnetic resonance (MR) Venography and flow measurements. In addition, the study identified extracranial factors that affect cerebral venous drainage.
In six of the IIH patients, either complete or partial functional obstruction of the internal jugular veins (IJVs) coupled with increased venous outflow through secondary venous channels was documented. On average, a four-fold increase in mean venous flow rate through the epidural and/or vertebral veins was measured in IIH patients compared with the healthy subjects.
In Bologna, Dr. Eliot Frohman discussed how normal pressure hydrocephalus reminded him of what Dr. Zamboni was seeing in CCSVI, and indeed, we know from new studies that the CSF levels in MS brains are affected.
Here is a study of intracranial venous congestion caused by an arteriovenous shunt-
BACKGROUND: Intracranial venous congestion is often caused by local venous thrombosis or brain arteriovenous fistulas. Hemodialysis shunts are known to cause venous enlargement in the arm or chest but have not been related to intracranial vascular pathology. Case Description- A 59-year-old woman who presented with increasing headache, gait instability, and memory loss was a renal transplant recipient who still carried a left upper arm shunt. Cranial CT scan showed enlarged veins in the posterior fossa with incipient hydrocephalus. Extracranial duplex sonography revealed reversed flow in the left internal jugular vein, which normalized on cuff inflation around the shunt-carrying arm. The reversed flow, intracranial venous congestion, and neurological status improved after surgical shunt ligation.
CONCLUSIONS: To our knowledge, this is the first case description of an intracranial venous outflow obstruction caused by a peripheral arteriovenous shunt.http://www.ncbi.nlm.nih.gov/pubmed/11740001
We see this extracranial venous congestion occur in hemodialysis patients:
We describe a 58-year-old woman who presented with bilateral ophthalmoplegia, exophthalmos, and headache and was found to have retrograde internal jugular vein flow secondary to a high-grade obstruction of the ipsilateral brachiocephalic vein from a previous hemodialysis catheter placement. The patient had also a high-flow dialysis graft in the ipsilateral arm. The cranial and extracranial venous system congestion resolved, and the signs disappeared soon after a balloon angioplasty and stent placement at the level of the obstruction.
http://linkinghub.elsevier.com/retrieve ... 8699704348
And now Dr. Zamboni, Dr. Zivdinov, Dr. Dake, Dr. Haacke, Dr. Sclafani, Dr. Sinan, Dr. Mehta, and many others around the world are finding a specific type of venous congestion caused by the extracranial blockage of the jugular veins. Venous congestion has long been associated with MS- since 1863 when Rindfleisch studied the blood engorged veins inside every MS lesion-- but the cause of this condition has not been understood.
When veins are blocked, they damage the organ they drain. This is why your insurance will cover opening up your veins if they are occluded over 50%--anywhere in your body. If your jugular vein had a clot, it would be anticoagulated and insurance would pay.
This is what Dr. Brandes is talking about. Venous congestion as it relates to congestive heart failure. Congestion
is the key word...I hope this breakdown helps some understand the concept.