This Is MS Multiple Sclerosis Community: Knowledge & Support

[1eye]

I was thinking that science could use some of the techniques used in stereo audio work. We could make use of common characteristics of the vascular and nervous systems: bilateral symmetry, asymmety, and left/right crossovers. Crossovers are very common in the bilateral parts of the nervous system.

They are less common in the circulatory vessels. There are some veins and arteries which are bilaterally asymmetrical. There are some parts of the CNS which are as well. There are more places above the neck, where crossovers occur in the CNS. than there are below the neck. In fact, the majority of them are above the neck. We should be able to localize problems into one system, if they commonly violate the handedness expected from the other system.

An example would be a lesion on the left side of the brain, which causes a nervous problem on the right side of the body. So far, everything is as expected. But the perivenous lesion is on the opposite side of the brain from where it should be, because all of the jugular stenoses found in this patient are on the right. There are few perivenous lesions on the left side of the patient's brain. Therefore the lesion was likely not caused by insufficient drainage on the right.

A similar determination, perhaps less likely, might be made if there are venous collaterals which cause a crossover, yet none is expected between problem and symptom, from the CNS. This presumes we can connect lesion sites with sites of disability more accurately than we probably can. This ability, however, might shed light on the problem. Both neurological and vascular knowledge and testing would be required.

[Cece]

We should be able to localize problems into one system, if they commonly violate the handedness expected from the other system.

You would think so. But we've heard from Dr. Sclafani that he's not seeing a correlation between where the CCSVI stenoses are and where our lesions are and what side of the body is affected most. I think it is complex....

[1eye]

I'd like to see it documented, because I think it could be important either way. One of the ever-growing list of things that need elucidation by "further study". I guess I would ask, if not, why not?

[Cece]

If not, why not....

I don't have an answer for that one.

For me, my jugular stenoses were bilateral, so there would have been reflux on both sides and impaired drainage altogether.

[1eye]

For some reason, people don't seem to get bilateral foot-drop. There seems to be a definite unilateral nature to this disease. My left arm, leg, and foot are all affected by weakness and paralysis. I would not be surprised to find that my brain lesions, or spine lesions, if that's what they are, are very heavily weighted, to the right if there is a brain cross-over.. I would say that the right side of my brain is more affected, because I have great emotional troubles, but can still put a sentence together. If so, that would indicate that there is a cross-over, affecting physical problems on my left side. I have no real idea, and have fired the neurologists. I would like to know if there is handedness to any of my lesions, the way I know there is, in my jugulars. I hoped to see Dr. Diana at the New York gathering, but didn't. I want to learn the likeliest source of my eye problem, which affects my right vision. On the surface it looks like my problems cross over at or above the neck.

I know my problems are not all on the left below the neck, just more and worse. Dr Siskin, I believe spent more time on my left jugular.. But the clot, if that is what it is, is on the right, which is currently where my remaining jugular problems (reflux, insufficiency) are also. It could be that is why my disabilities are still there on the left, if they are affected by the jugulars, and there is a brain cross-over.

One of my former neurologists promised me trouble on both sides eventually. I don't think my progression has stopped, because I failed my follow-up. So I will not be surprised to see my right side start to fail more visibly. I think there is some kind of intrinsic handedness to this disease because disabilities I have seen usually happen on one side more than the other..

If CCSVI is responsible for some, but not all of my MS symptoms, then whether and where crossovers are is important to know. The hospital has tons of my MRIs.

[phlebologist]

I was thinking that science could use some of the techniques used in stereo audio work. We could make use of common characteristics of the vascular and nervous systems: bilateral symmetry, asymmetry, and left/right crossovers.

Good idea. But there is a problem: main cerebral veins do not come in pairs, they are single (superior and inferior sagittal sinuses, great vein of Galen. Then, this centrally-located venous system divides and (not going into details) connect right and left internal jugular veins. Therefore, an unilateral obstacle in internal jugular vein can - theoretically - trigger a lesion in any side of the brain.
Still, there is one part of the brain that doesn't fit into this scheme: optic nerves. Interestingly, optic neuritis is more common on the left side (papers published in the sixties), and also neurodegeneration that can be demonstrated by OCT is more likely to be found on the left side (some unpublished data) - a phenomenon that is hardly explainable using autoimmune paradigm of MS. And now we know that CCSVI affects more frequently left internal jugular vein if compared with right side.(all published venographic studies have demonstrated this left/right difference, probably asssociated with embryological development of left IJV)

[Cece]

That is very interesting.

It's anecdotal but I fit such a pattern too: optic neuritis in left eye only and my CCSVI was especially severe with a 99% blockage on my left side.

[mavis]

Me too. Had ON on the left side (after which came the diagnosis), and I have a bum left jugular.

[Hooch]

Me too - optic neuritis in left eye but both jugulars moderate to severely blocked (Dr Siskin didn't give percentages).
However I also have high intraoccular pressure, especially behind the right eye so worry all the time about my sight.

[1eye]

The latest I've noticed is that I have a noticeably larger, pinker neck on the right hand side, opposite my disabilities. The only complication to my mind, is that Dr. Siskin did most of the work on my left; my right is said to now have more problems than my left. The disabilities have not moved, and have slowed down their progression, but are mostly still there. The only thing I can think is that I sleep mostly on my right and that blood is shifted to that side, perhaps redder than what is in my feet because in spite of it being slow, venous blood, it is still fresher than what is lower down. That's why your face goes red before you turn blue. It does look like the left side of my neck has atrophied too.

[1eye]

Reading the IVUS thread has made me realize that there are normal left/right differences in the size of jugulars. The right side dominance due to handedness is one possible explanation for both the jugular vein size and the increased incidence of left-sided disability. In fact, if this kind of statistic were found in "MS' there would be clearer understanding that the disease is more often congenital, and that handedness determines both vein size and the side that is likely to be disabled.

Anybody ever seen a study like that? Are there stats on these vein sizes in "normals"? Or is there another reason for the left/right size difference other than which hand you use?