CCSVI and CCVBP

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Postby costumenastional » Fri Oct 15, 2010 5:07 am

silverbirch wrote:I think some were along the line Ive got it into my head if the click goes wrong Im in trouble


This is most unlikely to happen.
It s gonna be ok. In fact, more than ok. Don't worry.
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Postby uprightdoc » Fri Oct 15, 2010 6:04 am

Silverbirch, perhaps the Spartan general from Athens, costumenational, can console and assure you. He isn't afraid of anything but like you he was nervous about getting adjusted. I'm sure a Dr. Heidi Grant is less scary than Dr. Koontz.
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Postby costumenastional » Fri Oct 15, 2010 6:26 am

:oops:
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Postby Cece » Fri Oct 15, 2010 6:58 am

uprightdoc wrote:Hello Cece, you keep slipping in and out of the conversation and I didn't get to say hello. Your Betty Boop like Avatar, however, catches my eye and makes me weak in the knees. That's something I won't explain.

lol, thank you.

I have not yet read the whole thread, so not much to contribute. You have some of my friends in here, though, and I want the best for them.
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Postby DrKoontzDC » Fri Oct 15, 2010 10:52 am

uprightdoc wrote:I'm sure a Dr. Heidi Grant is less scary than Dr. Koontz.


LOL
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Postby Ruthless67 » Fri Oct 15, 2010 9:35 pm

Hi All,

I tell ya, I find Dean Koontz's writings a whole lot scarier than Dr. Koontz's posts here, lol!

Happypoet, I'm so happy for you!!

Silverbirch, I wasn't scared, I guess because I've been seeing lower spine chiro's for years. But the adj. I got from the UC doctor that Dr. Flanagan recommended was very gentle. I also have a friend going with me who has to be handled with "kid gloves" and she has had no discomfort from the adjustment.

Lora
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Postby uprightdoc » Sat Oct 16, 2010 10:54 am

Hello KathyJ, I recieved and reviewed your records and your notes, which were very well done and most helpful. In brief, even without seeing the images yet, there is plenty that "jumps out" about your particular case. Your situation is somewhat similar to Fernando and CurIous. I will PM you when I am through.

This website is awesome. Nowhere else could you get such a conglomeration of so many diverse and yet cohesive findings regarding the cause of MS. Together, all of you contain a wealth of incredible and highly relevant clinical data. One of the things I discuss in my book is a retrospective epidemiological study. MS forums such as this one, would be a good place to start.
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Postby NZer1 » Sat Oct 16, 2010 11:06 am

And Dr. I must add without you we would not get the information we need. This latest part to the puzzle is a very, very good example, thank you.

MS Lesions of the Cervical Cord
uprightdoctor | October 16, 2010 at 10:34 am | Categories: amyotrophic lateral sclerosis, ccsvi, demyelination, liberation procedure, ms lesions, multiple sclerosis | URL: http://wp.me/p11lYi-zM



Image via Wikipedia
Multiple Sclerosis is technically a neurodegenerative disease of the brain. Classically MS is associated with two or more supratentorial (above the covering over the cerebellum) periventricular hyperintensity signals. Some MS patients, however, also get lesions in the cervical cord.

Demyelinating type lesions in the cervical cord without lesions in the brain is not considered to be classic MS. Lesions below the cervical cord are likewise not considered to be MS. Instead they are given different names.

In this post I will stick to MS lesions in the cervical cord and disregard lesions of the lower cord such as those seen in amyotrophic lateral sclerosis (ALS), primary lateral sclerosis, Devic's Disease (neuromyelitis optica) and others. I will also ignore the lesions sometimes associated scoliosis and abnormal curvatures of the spine.


According to Schelling, the lesions seen in the cervical cord in MS are due to stretch and shear stress. Many types of trauma, such as whiplash in the picture on the left, cause hyperflexion and hyperextension of the spine. The strain can occur in a front to back motion or from side to side. At the same time, whiplash type traumas also strain the spinal cord inside the spinal canal.

The spinal cord, like the brain has three protective coats called meninges. The outer coat is called the dura mater. The middle coat is called the subarachnoid mater and the inner coat is called the pia mater. Except for the attachment of tail end of the cord, called the filum terminale to the tail bone, called the coccyx, the spinal cord moves freely, unattached inside the spinal canal.




The three coats are held together by denticulate ligaments that attach the inner pia mater to the outer dura mater at the nerve roots. The subarchnoid space lies between the subarchnoid mater and the pia mater and contain a significant volume of cerebrospinal fluid, called CSF. There is also lymph like fluid that serves as a lubricant between the outer coat of the dura mater and the middle coat of the subarachnoid mater. This allows the inner contents of the cord to move somewhat independently to a limited degree.

According to Schelling, mechanical strains of the spine can take the cord to extreme limits of stretch. It can also cause shear stress within the cord between the pia mater on the outside and the dura mater on the inside. The stress points form at the attachment of the denticulate ligament. At some point the stress and strain can simply cause the myelin to break.

Furthermore, violent back jets of CSF in the subarachnoid space amplify the strain similar to boats moored to docks hit by hurricane type waves. The waves amplify the strain and rip the ropes and boats from their moorings. Similarly, violent waves of CSF flowing through the subarachnoid space amplify the strain and on the denticulate ligaments. When they reach a critical threshold engineer's call the yeild point, the denticulate attachments of the pia mater to the dura mater will tear.



The lesions seen in the cervical cord are micro tears in the meninges. The tears casues cause scars to form called sclerotic plaques. Because they occur on the outside along the flanks of the cord, the tears tend to effect the outside structures of the cord.

The outside of the cord contains the long myelinated high speed primary nerve pathways of the central nervous system. Primary nerves go from the brain to particular destination levels in the cord. The long white tracts on the outside of the cord contain both sensory nerves for detecting sensations related to the environment, muscle tone and balance, and motor nerves for running the muscles. Tears in the area of the denticulate ligaments thus affect nearby myelinated nerves in the cord resulting in muscle weakness and warped sensations called paresthesias.

In brief, according to Schelling, one of the likely causes of the lesions of multiple sclerosis seen in the brain are due to violent venous back jets associated with trauma. The lesions seen in the cervical cord are due to severe overstretching and shear stresses within the cord itself magnified by hydraulic stress from CSF waves. There is still more to the story, however, that needs further exploration and explanation. That's where my theory may help to fill in some of the still missing pieces to the puzzle that are starting to come together. My theory is that craniocervical syndromes can cause chronic edema (swelling), ischemia (decreased blood flow) and NPH (normal pressure hydrocephalus) conditions. These chronic conditions can in turn initiate neurodegenerative processes such as the glutamate cascade, which follows strokes.

In my next post I will discuss the posterior blood supply routes to the brain and circulation to the cord. The veins are not the only problems in MS. The arteries are a big part of the problem as well.

http://uprightdoctor.wordpress.com/2010 ... ical-cord/
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Postby NZer1 » Sat Oct 16, 2010 12:09 pm

After reading the above article if you conciser the flowing it helps even more with the big picture, thank you again Dr.

The Mystery of MS Lesions
Posted on September 30, 2010 by uprightdoctor

MS scars

The root of the word sclerosis means scar and multiple sclerosis is associated with multiple scars in the brain. Scars being what they are, it is unlikely that either the best upper cervical chiropractic care or surgical liberation procedure will lead to repair of badly damaged scarred tissues.

If you read the comments section you will see that many people with MS lesions recall severe trauma from many years earlier. Only in rare cases do the serious symptoms show up immediately or soon after trauma so no one would even think of looking for lesions in the first year or so after the accident. In fact, the interval of time between the traumatic incident and the onset of symptoms and lesions is one of the key issues in the medicolegal debate regarding the relationship between MS and trauma. The other issue is the cause or mechanism of injury. I discuss the medicolegal issue as well as a pertinent clear cut case or MS related to whiplash in my book.

By the time brain scans are done the scars can be many years old. On the other hand, I had the experience of treating cases where the signs, symptoms and lesions all started to show up in just about a year. Two of those cases where especially severe and resulted in significant disabilities. In any case, most lesions in MS are permanent scars.

Unfortunately, oftentimes the scars are in bad locations as far as signs and symptoms are concerned. For example, the cervical cord contains all of the long myelinated tracts that pass from higher centers in the brain down to the arms and legs to work the muscles. Damage to these long tracts can cause permanent muscle weakness. The goal in these cases should be to restore function and halt further progression and disability as much as possible.


The lesions or scars of mutliple sclerosis show up as bright spots called hyperintensity signals on MRI as seen in the brain scan on the right. Hyperintensity signals however are not unique to MS. Strokes and migraine headaches can also cause hyperintensity signals on brain scans in the area of impaired arterial blood flow.

MS hyperintesity signals are more characteristically located above the covering over the posterior fossa, which contains the cerebellum as seen in the sketch below. Hence, the covering is called the tentorium cerebelli. MS lesions are typically found in surpratentorial areas. Additionally, the hyperintesity signals are often found surrounding the chambers in the core of the brain called ventricles in the periventricular areas. The ventricles are the dark shadows in the brain scan above and chambers in the middle of the brain and brainstem seen in the sketch below.

In addition to the supratentorial and periventricular areas, instead of arteries, as in strokes and migraine headaches, the lesions in MS are more typically found in what are called perivenular areas around the larger dural sinuses (veins) of the brain. They also tend to get smaller in number and size as you follow the blood vessels upstream counter-current to blood flow. This is the complete opposite of what you would expect if viruses were the cause because viruses follow blood flow. Consequently, the lesions would tend to show up in areas closer to the source of the stream in the arteries first, not so much further downstream in veins. Condsidering all the above, it’s hard to picture how stenosis in such distant jugular and thoracic veins could cause lesions in to show up predominantly in the higher and core areas of the brain above the tentorium, and not more in the cerebellum, which is down in the basement of the cranial vault called the posterior fossa.

In addition to the brain, MS lesions are also sometimes found the cervical cord as depicted in the old sketch above. In contrast to the core of the brain, lesions in the cord tend to show up on the outside along its flanks which contain the myelinated tracts mentioned above. Rarely ever do MS lesions show up below the shoulders. While MS lesions stop at the shoulders, however, other similar conditions associated with scarring similar to demyelination seen in the cevical cord in MS, are seen in the lower cord, such as amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease and primary lateral sclerosis (PLS). A variant of ALS can reach up into the brain as well. It’s called bulbar ALS. There is also a variant of MS, called Devic’s disease, that is associated demyelination in the lower cord but optic neuritis in the brain. In addition to MS, I also treated patients with demyelinating diseases of the lower cord. At this time there is nothing anyone can do to stop the devastation in these conditions but I believe we are getting closer, and a flood of cranked-up highly motivated MS patients are leading the way. When Parkinson’s patients join the fray the pressure will increase three fold, so will the money for further research into venous drainage problems.

Interestingly, while Asians have a lower incidence of MS they do get demyelinating diseases of the cord such as Devic’s disease. I believe it has to do with design difference between Caucasian and Asian skull designs. I will be covering demyelinating diseases of the lower cord on my new website, which is not quite ready for public viewing yet. Suffice it to say that demyelinating diseases of the cord are probably due to similar design problems and circulatory causes as MS.

As far as the cause and location of the lesions of MS are concerned, Schelling’s theory makes the most sense. I will be discussing Schelling’s theory as to why the lesions show up where they do in my next post. I will also throw in some of my own two cents to add to the mix and maybe fill in some of the gaps. In brief, I believe that in certain cases of MS the hyperintensity signals and lesions are more likely to be due to to decreased arterial blood flow similar to migraines and mini strokes, not venous drainage problems.

While curing the scars may be difficult or impossible to do, the location of the scars are often in areas that have nothing to do with many of the unusual signs and symptoms associated with MS, such as optic neuritis, ringing in the ears, trigeminal neuralgia, speech problems, balance problems, fatigue etc. Even more interesting is that, except for the eyes, most of the nerves that would cause such symptoms are found below the tentorium in the posterior fossa. Most of the signs and symptoms associated with Parkinson’s disease likewise come from the posterior fossa. Slowy but surely, trauma is being recognized as a possible causative factor of Parkinson’s just like MS. Furthermore, since the lesions don’t come and go in MS they can’t be the cause of remissions and exacerbations of signs and symptoms.

Halting the progression of MS and improving signs and symptoms unrelated to the lesions is definitely possible by restoring fluid mechanics in the brain. Upper cervical correction is one way to do it. The liberation procedure is another. We are on a completely new path but we have only taken the first step. Things can only get get better as we learn more and continue to unravel the mystery of MS and the unique design of the incredible human brain due to upright posture. I believe upright MR and angiograms will shed much more light.
http://uprightdoctor.wordpress.com/2010 ... s-lesions/
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Postby silverbirch » Sat Oct 16, 2010 12:16 pm

Thank you all for your lovely words of reasurance

Dr Flanagan and Dr Dr. Koontz's
Its lovely to read that you enjoy the forum what a lovely thing to say xxxx

Maybe the neuro's will come into the forum one day and say the same !!!
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Postby NZer1 » Sat Oct 16, 2010 9:46 pm

After posting the articles from Dr. F i went to Dr. S's thread and replied to Cece on another thought and have copied it below;
Cece, I'm beginning to believe there is a balancing system within all of this system of blood drainage and CSF interplaying in the game.
The outcomes that are reported to some degree have consistency when you look at the area angio'ed compared with the symptom relief. The examples where there is no change or seemly unrelated symptom relief have me thinking there is more happening here than we are yet aware of.
My interest in the writings of Dr. Flanagan supports my belief, and I have always thought that the 'individual' nature of MS each of us experience has been a clue all along.
I have the feeling that the balance and disruption in the blood flow, blood supply, blood cooling, blood nutrients, blood waste removal, blood cushioning, CSF flows etc,etc are all interplaying with the nervous system not only from impinging or cushioning, demylination and other Neurological aspects as well.
This in my view is not only about blood flow in the jugulars and azygus areas, it is about an interplay system, more complex than we assume.
We are going to need a team effort here to link each part of a very complex system we know as MS, in a mutually beneficial way.
Later today;
I am now even more aware of the balancing in blood flow and CSF flow. When I talk with fellow PwMSers we all talk about waxing and waning of our symptoms. We also talk about seasonal changes. We also talk about the changes due to climate change within a day. For these changes to happen (like the RRMS experience of episodic MS) it is totally different to Huntingtons Disease and Strokes which are permanent with no going back unless the brain can retrain and utilize other areas of the brain to carry out functions. In MS for the symptom fluctuation to happen with an external change such as air pressure or temperature I believe it has more to do with fluids than conduction. Sure conduction can be effected by these factors but I believe it is secondary or separate.
Somewhere in this system of blood and CSF there is a link that has yet to be understood.
Another point that is occurring is that people have been having headache issues involved with the onset of MS, and now that people have had angio they are having either relief from a history of headache or head aches occurring post angio.
There is something to do with pressure or compression or something similar that is effecting the nervous system/tracks. Maybe there is something to do with position of the brain or cord as I believe Dr. F has indicated and we PwMS can help with our experiences to understand this better. Most Neurologists put their hands in the air when we talk to them about our waxing and waning or have off the wall opinions of electrical origin, I think Dr. F has more to offer.
Another common symptom that is experienced is the symptoms that occur when we first lie down and then after a period of time the symptom will change as though a fluid leveling effect happens and changes pressure on the nervous system somewhere and relieving the lie down symptom. Other positional symptoms occur that don't change after time in that position, in my veiw in this case the pressure on the nervous system stays constant until moving to another position when the fluid pressure on the system changes the nerve response.
Question;
The Thalamus involvement in MS is something that has always interested me because it is a junction for so many of the areas that are effected by MS. Blood flow to Thalamus or from?, or pressure balance in blood and CSF? or pressure from the brain not being supported?, or the iron deposition from blood flows?, or damage from lesion formation? Any thoughts here Dr. Flanagan, it seems that MRI indicates Thalamus and Hypothalamus involvement quite regularly?
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Postby NZer1 » Sat Oct 16, 2010 10:49 pm

Since I am giving your site some attention, :lol: I have just remembered some other things about my personal MS experience. Both my parents have had strokes, my mother had late onset diabetes, my fathers father had Alzheimer's disease, an Uncle on my fathers side has MS, and my blood lines are from Scotland and England. Live in NZ near 45th parallel, first to see the sun each day.
Regards Nigel
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Postby uprightdoc » Sun Oct 17, 2010 6:49 am

NZer1, you are catching on very quickly. Most people who are good with even basic mechancis usually do. Plumbers and master mechanics always get it. So do engineers, especially bioengineers like Haake and Alperin. It's all about fluid mechanics in the brain and cord.
Good question: The thalamus and hypothalamus recieve their blood supply from the vertebral-basilar arteries which pass through the cervical spine and enter the brain through the membrane between the base of the skull and C1. That membrane also contains part of the drainage and cooling system of the brain and has pressure receptors and switches for controlling blood flow and pressure in the brain. Compression of the vertebral-basilar arteries can lead to decreases blood flow and ischemic type demyelination in the distribution of the posterior blood supply to the brain. In fact, I believe they are more like little mini strokes called TIAs. I cover the topic thoroughly in my book and I will discuss the posterior blood supply to the brain in my next post on the blog.

You already have a considerable jump on most medical doctors and chiropractors including upper cervical chiropractors. The only chiropractor who truly gets all this regarding fluid mechanics in the brain is Dr. Chuck Woodfield of the Upper Cervical Chiropractic Research Foundation. Interestingly he knows Alperin and has done research projects with him. He is also a big fan of Haake's work as well. He read the book and said "You did an outstanding job, explaining difficult concepts in a way an avarage person can understand, all around a story that keeps you reading until the end." I am bringing him with me to Albany and want to see if I can get him to another CCSVI meeting in Miami. Things are starting to get very interesting.
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Postby NZer1 » Sun Oct 17, 2010 12:59 pm

Thanks Dr. F. Two things, there are some VERY interesting questions asked of Dr. S today I think there are more people understanding that there is more to MS than a quick fix of the jugs.
Secondly I have noticed in the last week that when I am bending over weeding in my garden that after being bent over for five or so minutes that I stand and feel light headed. At various times over the last 5 years I have been suspicious of low BP and asked our MS nurse to check it. We have checked in various situations including the gym and throughout the testing I have been able to pick when my BP is low. When I have been at the GP Doctors naturally I have shown normal BP and it has always been put down to the nurse not doing her tests correctly, she is angered and hurt by the words of my GP naturally. Any way I am wondering if there is anything that could be making my BP fluctuate and at present I am aware of it more as my disease is active because we are having big weather changes for spring, from snow to hot also summer weather and my symptoms seem to be more progressive and active in this weather pattern.
Being a mechanic and then becoming interested in Human Development and training at University (had to stop because of my MS and cognitive issues and exam pressures) I am probably overly aware of changes in my health and have a need to understand what and why. I have read some more of your book last night and feel as though I copied your content after reading about what I had recently posted, I feel now that I am understanding the importance of your work and the benefit we all will receive. Thank you Dr.
I would like to get you and Dr. Zamboni and then Dr. Haacke and Dr. Hubbard working together on this. There is huge learning curves here that the world will benefit from if we can get you all talking!
Regards Nigel
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Postby silverbirch » Sun Oct 17, 2010 1:13 pm

NZer1 wrote:(had to stop because of my MS and cognitive issues and exam pressures)Nigel


Nzer1 when I read your postings I want to understand them and I do read and re read , and re read I go and make a cup a tea to read them over and over I want to understand them so much

I to gave up my degree in Health safety law for simular reasons

You say problems with your cognitive thought( I do understand what you mean..) but my goodness your memory seems top notch just by reading your post

Im off to make a cup of tea
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