This time it come from Swedish MD team from Umeå University Hospital:
Venous and Cerebrospinal
Fluid Flow in Multiple Sclerosis:
A Case-Control Study
Peter Sundstrom, MD, PhD,1
Anders Wåhlin, MSc,2 Khalid Ambarki, MSc, PhD,2
Richard Birgander, MD, PhD,2
Anders Eklund, MSc, PhD,2,3,4
and Jan Malm, MD, PhD,1
1 Department of Clinical Neuroscience, Umeå University, Sweden;
2 Department of Radiation Sciences, Umeå University, Sweden;
3 Department of Biomedical Engineering and Informatics, Umeå University Hospital, Sweden;
4 Center for Biomedical Engineering and Physics, Umeå University, Sweden.
The prevailing view on multiple sclerosis etiopathogenesis has been challenged by the suggested new entity chronic cerebrospinal venous insufficiency. To test this hypothesis, we studied 21 relapsing-remitting multiple sclerosis cases and 20 healthy controls with phasecontrast magnetic resonance imaging. In addition, in multiple sclerosis cases we performed contrastenhanced magnetic resonance angiography. We found no differences regarding internal jugular venous outflow, aqueductal cerebrospinal fluid flow, or the presence of internal jugular blood reflux. Three of 21 cases had internal jugular vein stenoses. In conclusion, we found no evidence confirming the suggested vascular multiple sclerosis hypothesis.
...If MS-CCSVI is an entity associated with MS, the association is likely to be weaker than previously reported, and most importantly, we found no support for a treatment rationale of endovascular procedures like angioplasty or stenting.