This Is MS Multiple Sclerosis Community: Knowledge & Support

Did some googling of venous valves and came up with this cute animation of how they work. It's only four seconds:

http://www.doereport.com/generateexhibit.php?ID=14555&ExhibitKeywordsRaw=&TL=4294967295&A=

Looks like sting ray wings to me.

So those are the leaflets? The two flapping parts...so if those are fused, it's as simple as that, blood flow is cut off.

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"However, the truth in science ultimately emerges, although sometimes it takes a very long time," Arthur Silverstein, Autoimmunity: A History of the Early Struggle for Recognition

...or inverted

This is a neat animation !! When I was at BNAC last week they discovered a "flap" in my left IJV using the doppler sonography. I posted pictures on my earlier thread. Give me a minute and I will repost them.

thanks for posting this Cece
for me, the visual, graphic (vs written) is so much a better way to understand!

Now to learn mad graphic animation skills and create animations of the ways valves go wrong...

I'd been under the impression that it was structural abnormalities of the walls of the veins that made up the most of CCSVI...you know, the missing jugulars, the thickened jugulars, the double jugulars. Dr. Sclafani says, no, it's mostly a valve issue.

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"However, the truth in science ultimately emerges, although sometimes it takes a very long time," Arthur Silverstein, Autoimmunity: A History of the Early Struggle for Recognition

Zamboni did a good job of classifying the stuff he saw in his first study. Table III breaks down the different issues he found in his 65 MS patients. About 46% had valve issues. Click on the link to see the table:
http://db.tt/OmXJE8

http://www.ncbi.nlm.nih.gov/pubmed/6460930

I thought this was interesting. We've talked about the malformation of internal jugular vein valves as happening during embryological development. I had never heard about changes in the valves occurring after birth. What sort of changes? "Disappearance or persistence"? How could a valve disappear?

Very interesting. Did you go through all the related citations? It's a veiniac's gold mine! One of the studies discussed how valves become malformed. I should have marked it but was kind of binging on all the studies and lost my head...and I don't even like veins!

Donald Reid said the same to me when Emma had her procedure in Dec 2010 in Scotland. They were coming across valve issues in pretty much every patient.

Hi! i was wondering if u have valve issues then what would happen to the blood flow?
In my case, on my Doppler USG, the sonographer couldn't see my valves in both my jugular, but there's no reflux in both IJV. Or if u have no valves then the reflux only happens if u have valsava maneuver, is it like that?

So do you think i should do another Doppler USG to know whether there is reflux in my IJV when doing valsava maneuver?

Please help me, cause my doctor really don't know anything about CCSVI besides from the reading materials i gave him.

Thank you for your information.

Warm regards,
Linda

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Warm regards,
Linda

|For the joy of the Lord is your strength | A cheerful heart is good medicine, but a crushed spirit dries up the bones| God always leads us to where we need to be, not where we want to be|

linda
a normal valve is some endothelial cells fixed in a collagen matrix. A normal valve is often not visualized except at its thickest part where the valve attaches to the wall of the vein (at the annulus). On ultrasound the valve may not be seen if the valve is not thickened or if it moves too quickly. In MS valves are usually slightly to moderatly thickened and they move more slowly, allowing their visualization.

In MS the overwhelming majority of patients will have abnormal valves that may be fused but cannot be seen on ultrasound because they are not yet thickened.in a perfect world venography would be the next step, but given how most insurers will not pay for this treatment, we have to use less costly

Most ultrasonographers do not have much, if any experience with ccsvi, and often miss things that are indicative of ccsvi
. So if you get another ultrasound, please go to someone who has considerable experience in this diagnosis.

if the valve is obstructed, generally what happens is that the vein above the stenosis starts to dilate or enlarge. Slow flow or stasis (absence of outflow) occurs. This leads to reduced arterial inflow, poorer perfusion with oxygenated blood into the brain and reduction in cerebrospinal fluid drainage and possibly hydrocephalus. Additionally, when the muscles of the neck contract, they MAY cause the pressurization of the blood within the vein. In the presence of obstruction toward flow into the heart, this blood may jet into the skull and injure deep cerebral veins.

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

Dear dr. Sclafani,

Thank you for your explanation...i have to read it many times in order to understand what you're saying. Pardon me, my english is not so good.

So you said that maybe my valve is there but it just can't be seen because maybe my valve is just very thin and move so quickly. If it is the case then does it mean that my valve is okay? Coz during my examination, as a comparison, my doctor had my healthy husband to be checked by the same Doppler USG, and we can see the valve very clearly in his IJV.

From my CT Venogram and Doppler USG result, my doctor said that there is no stenosis, no reflux, no absence flow in both IJV . But you said that "if the valve is obstructed, generally what happens is that the vein above the stenosis starts to dilate or enlarge. Slow flow or stasis (absence of outflow) occurs". Yes, in my right IJV my doctor noticed a slow flow in all part of the right IJV (from prox, mid to distal area). Could this slow flow happened because my doctor pressed my neck to hard during the examination?

And you said "This leads to reduced arterial inflow, poorer perfusion with oxygenated blood into the brain and reduction in cerebrospinal fluid drainage and possibly hydrocephalus." But my doctor said there is a hyperacceleration in my arterial flow? Does it mean an increased in arterial inflow?

You said "Additionally, when the muscles of the neck contract, they MAY cause the pressurization of the blood within the vein. In the presence of obstruction toward flow into the heart, this blood may jet into the skull and injure deep cerebral veins." I wonder what activities that can make my neck contract?

And if the obstruction in my IJV's valves is an absence of those valves, then what would happen to the blood flow or what is the impact then?

Oh dr. Sclafani, i'm sorry to ask u so many questions. I wish u could be my doctor:-)

Or maybe, i just have to see another sonographer then? Do you happen, by any chance, to know some one who can do this procedure accurately in Asia? Coz i live in Indonesia and there's never any CCSVI examination done here before, if it wasn't for me. There's so little case of MS here compare to the other countries in America or Europe or Australia.

Please dr. Sclafani, tell me what to do?

Thank you for your time and thank you for your quick reply.

Warm regards,
Linda

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Warm regards,
Linda

|For the joy of the Lord is your strength | A cheerful heart is good medicine, but a crushed spirit dries up the bones| God always leads us to where we need to be, not where we want to be|

Endothelial cells and collagen are mentioned in research as the target areas for intracellular bacterial infections to source the ATP they need for their life support and cell division (multiplying), just saying

Maybe there this a connection, CPn/Valve dysfunction?

The diseased cells, dysfunctional cells, hardened valves may have been scared by the infection/inflammation process over time? Pre-birth and Post birth!

Blood flow is one of the many transport mechanisms around the body for eg CPn and artery walls are known to be diseased by CPn and cause arterial plaques .

Ever searched for a needle in a hay stack? Testing for and finding CPn bacteria is pretty much equal in probability at this point in time, btw.

What makes Chlamydia Pneumoniae (Cpn) so troublesome?

While it may start as a respiratory infection, Cpn can be carried to other parts of the body and infect many other tissues, including nerve tissue, the brain, muscles, the lining of blood vessels and even your immune cells (macrophages).

Standard single antibiotic courses (two weeks) only kill Cpn in one of its three life phases, leaving live forms of Cpn bacteria which are in other stages to renew infection.

Cpn contains at least two endotoxinsi (toxic chemicals) which cause tissue damage and inflammationi, chronic immune activation and toxic load in your body.

Cpn infects inside your cells and parasitically steals energy from your own body cells in order to replicate.

The only way to cure it is to take a combination of antibioticsi, to kill it in all of it's life phases so nothing is left behind to re-infect.

As you can possibly tell this is my favourite subject since dx,
Nigel

Hi! i found this interesting book about venous valve. Haven't finished reading it yet (only the first 2 pages...hahaha).

It explains about venous valve and primary chronic venous disease. Maybe it could help us to understand how the valves work in our veins. The book is called Medicographia, The Venous Valve and Primary Chronic Venous Disease, Issue 95. Here's the link :

http://www.medicographia.com/wp-content ... phia95.pdf

And oh dr. Sclafani, i'm still waiting for more of your explanation if you have time.

Thank you very much.

Warm regards,
Linda

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Warm regards,
Linda

|For the joy of the Lord is your strength | A cheerful heart is good medicine, but a crushed spirit dries up the bones| God always leads us to where we need to be, not where we want to be|

Dear Linda
i am so sorry that i cannot convey clearly enough what i said to you. First you must understand that I was speaking in a general way. I cannot speak directly about your personal condition because I have not met you, have not examined you and have neither performed nor interpreted your imaging.

I do not know anyone in indonesia who is familiar or expert in CCSVI screening, diagnosis or treatment

DrS

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