as Google sees it:
Venous insufficiency in the brain found on MS
MS patients appear to have an abnormal venous blood flow in the brain. That is suggested modern imaging techniques. Whether the problems are the effects of MS or influence the course of MS is still unclear.
By Martin Wiehl
Venous insufficiency in the brain found on MS
Model of the brain vessels. Clearly, in MS patients also disturbed the venous blood flow in the brain.
© Sebastian Kaulitzki / fotolia.com
TORONTO. Clearly show both extracranial as well as intracranial veins of people with MS to significant changes. Then two groups of researchers from Italy and the USA have drawn attention. The disturbances, which they describe as chronic venous insufficiency, cerebro (CCSVI) could, in part only now be made visible by newer imaging techniques. The observations of a stir at the Congress of the American Neurological Society (AAN) in Toronto a lot of attention and were discussed extensively.
Reduced venous volume in the brains of MS patients
Basically, the total volume of the intracranial veins seems to be reduced. This includes especially the smallest veins. Moreover, it is presumed that MS patients have a chronic venous outflow obstruction caused by stenosis in the extracranial head veins. This will probably turn to a decreased perfusion of the brain tissue. Third, the venous outflow obstruction appears with a reflux into the cerebral veins einherzugehen. This will in turn have an increased iron deposition in the brain result. Corresponding to these venous flow anomalies suggest further investigation, that the cerebro-spinal CSF flow in the Sylvius Aqueduct is disturbed.
To capture the venous vascularization of the parenchyma, the researchers used an MRI-variant, Susceptibility-Weighted Imaging (SWI). This allows cerebral veins represent directly by the oxygenation of venous blood is used. A working group of Dr. Guy U. Poloni from Buffalo in the United States had applied the method in 62 MS patients and 33 healthy volunteers. They measured not only the total volume of the cerebral veins, but used it in relation to the total brain mass, head size and brain atrophy to turn off as disturbances. Overall, the total venous in MS patients by nearly 20 percent was lower (67.5 versus 82.7 ml) than was in the healthy, and the venous volume per brain mass is reduced by the same magnitude. The largest deviations were observed in veins less than 0.9 mm in diameter. Overall, the researchers placed near the findings of a severe impairment of the venous system in the brain-MS patients.
Similar conclusions were also an Italian group led by Professor Paolo Zamboni came from Ferrara in Italy. The Angiologist had in 16 patients with relapsing-remitting MS and eight healthy subjects first venous hemodynamics hirnableitender extracranial vessels as the internal jugular vein by Doppler ultrasound study. In all 16 MS patients, he found a venous insufficiency and venous back, but in none of the participants without MS.
Furthermore, all participants were examined with a further MRI procedure, the perfusion-weighted imaging (PWI). This in different brain areas of the cerebral blood flow, blood volume and mean transit time was recorded and analyzed separately. The result: The stronger the venous insufficiency in Sono was, the stronger was measured by PWI intracerebral perfusion disturbed. This correlation occurred in all regions of the parenchyma of MS patients and was particularly noticeable in the thalamus, caudate nucleus, putamen, hippocampus and nucleus accumbens.
With increased venous insufficiency of iron in lesions
In the same study population, the working group also used the SWI to detect increased iron deposits in the brains of MS patients. It was finally suggested that elevated cerebral venous reflux may contribute to such a rise. The iron concentrations were measured in different brain regions, and thereby also in T1-and T2-weighted lesions. It turned out that MS patients with marked impairment of the jugular veins actually also had a high iron load in the lesions. The stronger the venous insufficiency, the more iron was in the lesions. This is also clinically significant: So other researchers found that high iron concentrations in the gray matter associated with a marked degree of disability.
First, the findings should also be reproduced by other groups, said the AAN. Then could you clarify what importance the neurological venous anomalies have generally, and in what context they relate to the autoimmune process in MS.
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