Cerebral Venous Thrombosis in MS and Corticosteroid-study

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Cerebral Venous Thrombosis in MS and Corticosteroid-study

Postby North52 » Wed Sep 29, 2010 4:33 am

This is an interesting study on on the association of MS exacerbations, steroid use and cerebral venous thrombosis. Here is the link.

http://www.psychiatrictimes.com/display ... 0168/56831

I have not looked though the references yet but they seem to be very interesting. There are a number of reports mentioned regarding cerebral thrombosis following lumbar puncture or steroid in ms. They seem to indicate that the thrombosis was secondary to either the steroids or lumbar puncture. I have not read the studies but I suspect these may be just associated events and not cause and effect. Perhaps the initial exacerbations were cause by the thrombosis themselves.

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Not a study

Postby MarkW » Wed Sep 29, 2010 4:51 am

Hello North,
This was not a study but a case report of one patient. Unless there are more similar case reports it is best ignored.
Kind regards,
Mark Walker - Oxfordshire, England. Retired Pharmacist. 16 years of study about MS.
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Postby North52 » Wed Sep 29, 2010 5:22 am

Dear Mark,

Thanks for pointing out the correction. This was a slip on my part.

Re case reports, I do agree they come nowhere close to double blind randomized clinical trials, but I do nonetheless feel they are value or at least of interest and can be informative if scrutinized appropriately and taken in context. The link is to one case report but the references indicate that there were a number more. I really do not think these reports should be ignored. Although they prove nothing, they are nevertheless plausible and consistent with the current theory of CCSVI. These events prior to CCSVI were very difficult to explain. They mentioned steroids as possible cause, but steroids are not thrombogenic, nor to my knowledge are lumbar punctures.

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Postby cheerleader » Wed Sep 29, 2010 7:06 am

Hi North--
there will be a few of those head scratcher studies that might make more sense within the vascular paradigm. I'd seen that study and there are actually more on venous thrombosis in MS-
Here's 2 more patients after LP
http://content.karger.com/ProdukteDB/pr ... &doi=47949
Here's a woman where contraceptives are considered at fault:
Here's another woman-

Granted, this is not the majority of MS patients, but it is interesting to note venous thrombosis in MS. Another head scratcher is high liver enzymes in MS. Many studies on that, and even prior to DMDs, some pwMS present with high liver enzymes.

My best guess has been that the coagulation cascade is initiated after a breech of the blood brain barrier in the MS brain, due to venous congestion. That's what I saw in my husband at his first flare (his blood numbers indicated this), and that's what got me looking at these connections to blood and the endothelium.

Here's some info on the coagulation cascade, if you're interested. It explains the activation of thrombin and fibrin (those fibrin cuffs in the MS brain are another indicator)
http://themedicalbiochemistrypage.org/b ... ation.html

fascinating stuff, and I'm glad to know more doctors are looking at this connection now-
Here's the Neurology Dept at Lousiana State Univerisity--MS as a Vascular Disease, from 2006. Lots in here on cerebral endothelial cells
http://www.shreveportphysiology.com/Ale ... MS.pdf.pdf
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
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