This Is MS Multiple Sclerosis Community: Knowledge & Support

FINDINGS: On the right, the right internal jugular vein valve was visualized and appeared to be normal. The cross-sectional area of the internal jugular vein was 1.79 cm/squared in the supine position and 0.10 cm/squared in the upright position. Flow was present in the internal jugular vein, both in the supine and in the upright positions. There was no evidence of reflux in the vertebral vein, both in the supine and in the upright positions. However, there was evidence of reflux in the internal jugular vein in the upright position but no evidence of reflux in the supine position.

On the left, the left internal jugular vein valve was visualized and appeared to be normal. The cross-sectional area of the internal jugular vein valve at the level of the mid-thyroid was 1.02 cm/squared in the supine position and 1.11 cm/squared in the upright positions. Flow was present in the internal jugular vein, both in the supine and in the upright positions. There was evidence of reflux in the internal jugular vein in the supine and in the upright-positions; however, the vertebral vein was competent both in the supine and in the upright positions.

IMPRESSION:
1. On the right, one out of four criteria met for chronic cerebral spinal venous insufficiency.
2. On the left, two out of four criteria met for chronic cerebral spinal venous insufficiency.

I just received my official "Preliminary Report" results back from the Eastern Maine Medical Centre:


So, I still have some evidence of CCSVI... and I'm wondering what that means and what I should do now. Looks like my best source of info (for now) still might be TiMS, though they are supposed to send the images to Barrie, so I might eventually get some answers from Dr. McDonald, as well.
...Ted

Anyway, if someone knows of some metrics concerning what constitutes "bad" flow or how "bad" it should be before a person gets concerned, I'd like to hear about it.
...Ted

Ann Neurol. 2011 Jan;69(1):90-9. doi: 10.1002/ana.22228.
No evidence of chronic cerebrospinal venous insufficiency at multiple sclerosis onset.
Baracchini C, Perini P, Calabrese M, Causin F, Rinaldi F, Gallo P.
SourceFirst Neurology Clinic, University Hospital, Padova, Italy. claudiobaracchini@tin.it

Abstract
OBJECTIVE: An impaired cerebrospinal venous drainage, defined as chronic cerebrospinal venous insufficiency (CCSVI), has been recently hypothesized to be the possible cause of multiple sclerosis (MS). We investigated this hypothesis by studying the occurrence of CCSVI in clinically isolated syndromes (CISs) suggestive of MS.

METHODS: Fifty consecutive patients presenting with a CIS and evidence of dissemination in space of the inflammatory lesions (ie, possible MS [pMS]) underwent a detailed diagnostic workup, including extracranial and transcranial venous echo-color Doppler sonography (ECDS-TCDS). Those with CCSVI underwent selective venography. Fifty healthy subjects (HCs) age-matched and gender-matched with pMS patients (HC1); 60 patients with transient global amnesia (TGA); and 60 healthy subjects age-matched and gender-matched with TGA patients (HC2) constituted the control groups and underwent ECDS-TCDS.

RESULTS: Mean age of pMS patients was 33.0 ± 8.5 years (range, 14-50); 35 (70%) were female (female:male ratio, 2.3). TCDS was normal in all pMS patients. One or more abnormal ECDS findings were observed in 26 of 50 (52.0%) pMS patients, in 35 of 110 (31·8%) HCs (HC1+HC2), and in 41 of 60 (68.3%) TGA patients. Eight (16%) pMS patients fulfilled the diagnosis of CCSVI. Selective phlebography performed in 7 of these patients (1 denied consent) did not show venous anomalies.

INTERPRETATION: Our findings do not support a cause-effect relationship between CCSVI and pMS. Further studies are warranted to clarify whether CCSVI is associated with later disease stages and characterizes the progressive forms of MS.