Comment on: Use of MR Venography for Characterization of the Extracranial Venous System in Patients with Multiple Sclerosis and Healthy Control Subjects
Zivadinov R, Lopez-Soriano A, Weinstock-Guttman B et al. Radiology. 2011;258:562–70
Kira Lutz, Alexander Radbruch and Martin Bendszus
Volume 21, Number 1, 41-42, DOI: 10.1007/s00062-011-0062-9
The most important issue remains the correct interpretation of these venous variants in terms of possible pathophysiological relevance, clinical consequences and necessity of treatment. Even patients with real impaired venous cerebral outflow (such as venous sinus thrombosis, pseduotumour cerebri, elevated central venous pressure, secondary venous outflow obstruction due to cerebral infarctions, surgical resection of the neck veins due to treatment of head and neck tumours etc.), show no increased prevalence rates of MS as described by Khan et al. .
"Even patients with real impaired venous cerebral outflow"??
My blockages were 80% and 100%. That is plenty real.
(As for the point that other patients with venous cerebral outflow problems not getting MS, the counterpoint is that it typically takes 30 years for the onset of MS and that I am very interested in seeing data on such patients 30 years after their outflow obstruction onset.)