]The etiology of age-related white matter changes is unclear. Cerebral white matter changes on magnetic resonance imaging (MRI) and progressive dementia have been reported in patients with dural arteriovenous fistulas of the sigmoid sinus. The frequency of jugular venous reflux, which mimics a dural arteriovenous fistula, significantly increases with age. We investigated whether jugular venous reflux was associated with the severity of age-related white matter changes in 97 persons (aged 55–90 years, mean [standard deviation]: 75.77 [8.19] years; 55 men) from a medical center memory clinic.
MRI (1.5T) and the semiquantitative Scheltens scale were used to investigate the severity of white matter changes. Subjects were classified into 3 groups (no, mild, and severe jugular venous reflux) by duplex ultrasonography.
Subjects with severe jugular venous reflux had more severe age-related white matter changes in occipital subcortical, thalamus, pontine, and summed infratentorial regions compared with subjects with no jugular venous reflux (all corrected p< 0.0166), especially subjects aged ≥75 years (corrected p< 0.0166 in occipital subcortical; corrected p< 0.0001 in pontine and summed infratentorial regions). In subjects ≥75 years, we further noted that the whole brain age-related white matter changes rating scores were higher in the severe jugular venous reflux group than the no and mild jugular venous reflux groups (corrected p< 0.0166).
People with severe jugular venous reflux exhibit more severe age-related white matter changes, especially in caudal brain regions. We also demonstrate age-dependent jugular venous reflux effects on the severity of age-related white matter changes. These findings may provide new clues into the pathophysiology of age-related white matter changes. ANN NEUROL 2011
Cece wrote:A year ago, Poland was one of the only options for CCSVI (with Dr. Simka). Now that there are more options, it is possible for patients to go local or maybe have a short plane ride instead of a long one. The closer you are treated to your home, the easier it is to have follow-up appointments. And less stress from travelling.
There are people posting at TIMS for whom Poland is local. I would encourage them to go local as well.
cheerleader wrote:Rici did go local, he lives in Poland. That's how he met Dr Simka. He is now recommending a different clinic. I met Dr. Simka at the Bologna conference and I recommended him to Erika on the boards in '09, since she lives in Slovakia--a train trip away.
I think what's important to note in Rici's case is that opening up the jugular vein, in his case, made his MS worse, because his reflux continued, even without a stenosis. I hope Rici won't mind me mentioning this, but I do believe he is in his mid-60s, and not a very young person.
His case reminds me of Dr. Chung's research into white matter lesions in the elderly due to valvular insufficiency. The veins became stretched out, and reflux occured. This is exactly what happened to Rici---the diameter of his vein grew. I worry terribly about people having valves removed, for this very reason. We do NOT know how aging effects reflux in the jugular veins, and it appears to be a problem for many. I think people need to consider this before having valves removed.
http://onlinelibrary.wiley.com/doi/10.1 ... 22276/full
If jugular venous reflux increase with aging, even in those without MS...people had better think about the need for working valves as they age. And I think patients need to really understand why they have reflux...is it a truncular venous malformation? Missing vein?
Dr. Schelling has spoken out about venous backjets, and has said we STILL do not know the whole story. Something to consider.
Puma wrote:High Rici
I am gratefull for you to find these new ways for all of us. You are pioneer both for having stent and narrowing the diamenter of the vein in open surgery. Having one vein closed and second one too wide you were born to have MS and finding the way for the new possibilites for us all. So say my friends.
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