JUGULAR VEIN COMPRESSION

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

Re: JUGULAR VEIN COMPRESSION

Postby Cece » Wed Feb 22, 2012 5:35 am

civickiller wrote:the vein can expand because c1 is movable with c2 front to back but because the muscles holding c1 in place learned that crooked position it will move back to that relearned position.
The jugular vein can expand during the procedure, under conditions such as breath-holding.
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Re: JUGULAR VEIN COMPRESSION

Postby civickiller » Wed Feb 22, 2012 3:02 pm

Cece wrote:The jugular vein can expand during the procedure, under conditions such as breath-holding.


i dont understand the point of this statement.
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Re: JUGULAR VEIN COMPRESSION

Postby Cece » Wed Feb 22, 2012 5:13 pm

Cece wrote:http://www.isnvd.org/files/ISNVD%20Abstract%20Book.pdf
from the isnvd 2012 consensus document:
Frequently, the transverse process of the C1 vertebra will visibly indent the jugular vein (since the vein lies on this bony structure) however, a balloon will inflate under minimal pressure and Valsalva maneuver will enlarge the compressed vein during angiography or IVUS confirming this normal relationship.
I'm working through this sentence in the ISNVD consensus document. The vein is indented by the atlas, but not compressed on the other side, and can expand depending on respiration, and is therefore called a normal relationship and does not warrant treating during angioplasty. But is there reflux caused by the indent by the atlas.
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Re: JUGULAR VEIN COMPRESSION

Postby civickiller » Wed Feb 22, 2012 11:28 pm

civickiller wrote:the vein can expand because c1 is movable with c2 front to back but because the muscles holding c1 in place learned that crooked position it will move back to that relearned position.

maybe thats why the ccsvi surgeries benefits arent lasting that long for some. this makes sense to me as to why my first ucc adjustment i found the same benefits as those who only felt symptom relief with the ccsvi surgery and why some people are needing to have the surgery over and over again

i like this ucc theory because its more provable than alot of the ccsvi assumptions.

im not saying ucc is the magic cure, i wish it was. ccsvi dr's need to start looking beyond what they think they know, just like what Dr Flanagan is with ccsvi. this is imo, it makes more sense


c1 only touches the vein from one side so itll only be indented on one side.

i dont think the indentation of the vein is normal at all. i think its pure stupidity for them to say c1 is visibly being indented but not wonder why c1 is doing that. oh yeah they say its congenital :roll:
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Re: JUGULAR VEIN COMPRESSION

Postby EJC » Thu Feb 23, 2012 9:53 am

The question is at what point does an "indent" become a "stenosis".
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Re: JUGULAR VEIN COMPRESSION

Postby Cece » Thu Feb 23, 2012 11:17 am

Or if anything can be done about the indent. We don't know if upper cervical care does anything for this. If the atlas is big, it might just so big that it'll push on the jugular regardless.

This is personal for me, I had upper narrowings noted in both jugulars during my angiography but they expand under valsalva. During my pretreatment ultrasound, my left jugular was entirely closed off when I looked straight ahead, but opened up when I turned my head to the right. What was the reason for it being closed off when I looked straight ahead?

I am much improved from before my CCVSI procedures, but I'm not 100%, and I am wanting to do what can be done in terms of diet and exercise and neck stretches (if any muscular compression is going on) because being healthier is wonderful.
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Re: JUGULAR VEIN COMPRESSION

Postby civickiller » Thu Feb 23, 2012 2:47 pm

the atlas isnt that big but it is, there is enough room for the veins

the atlas turns with the head, it maybe the situation your having off enough in a way to produce the situation your having. ie. normal atlas with head straight assuming the vein runs behind the atlas = | but its misaligned so atlas now = \, cutting off the vein on the left side with head straight, but turning to the right produces a | atlas freeing the obstruction

but i am no way a dr but thats my take on it
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Re: JUGULAR VEIN COMPRESSION

Postby HappyPoet » Thu Feb 23, 2012 6:12 pm

civickiller wrote:the atlas turns with the head, it maybe the situation your having off enough in a way to produce the situation your having. ie. normal atlas with head straight assuming the vein runs behind the atlas = | but its misaligned so atlas now = \, cutting off the vein on the left side with head straight, but turning to the right produces a | atlas freeing the obstruction

Dr. civickiller, your explanation is fantastic. :)

Cece, perhaps it's time to see an AO chiro. In the meantime, now you have an idea why sleeping on your side is helping? Your new theory is starting to come together. :)

I just can't leave this topic without saying that the groundbreaking large, randomized, and blinded FONAR Upright MRI Atlas Orthogonal study I was in last summer gave me a "notable" increase in the flow of my CSF after my Atlas was adjusted. :)
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Re: JUGULAR VEIN COMPRESSION

Postby civickiller » Thu Feb 23, 2012 9:36 pm

thanks HP :thumbup:

i cant wait for the next ucc study, Dr Rosa was talking about seeing Chiari 1 malformations in ms people, maybe that or maybe the nerve signals regained from ucc, i thought i remember seeing something like that on house with nerve signals.

hopefully another ucc dr does another upright mri csf study to replicate the results
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Re: JUGULAR VEIN COMPRESSION

Postby HappyPoet » Thu Feb 23, 2012 11:31 pm

Dr. civic,
You reminded me I forgot to say the new MS-only cohort study by the same doctors, including Dr. Rosa, is planned for later this year, again in Latham (Albany), NY. Anyone interested in being recruited, please let me know by PM, thx. :)
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Re: JUGULAR VEIN COMPRESSION

Postby civickiller » Fri Feb 24, 2012 12:10 am

HP, do you know what this study is going to be about?
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Re: JUGULAR VEIN COMPRESSION

Postby HappyPoet » Fri Feb 24, 2012 6:58 am

Dr. civic,

The study last summer was filled with all kinds of patients of the participating AO chiros; only two patients entered the study with a diagnosis of MS. As far as I understand, the MS-cohort study will be the same design as the first, but since only MS-diagnosed patients will be enrolled, recruitment of the needed 40 MS patients for this study will likely take longer than recruitment for the first.

The goal of the first study was to evaluate if AO chiro is effective for reestablishing proper flow of CSF which only an Upright MRI can show happening (power of gravity when seated upright); however, for the MS-only study, another goal will be a follow-up that includes MS specialists, neurologists, or primary doctors (or whatever docs we use for our MS).

Study participants need to spend one day in Latham (suburb of Albany). Patients not randomized into the control group will have two Upright MRIs done--one before and one after the real adjustment. Patients who are randomized and have the 'sham' adjustment will have a third Upright MRI done after their real adjustment.

I forgot to say this in my previous post: Thanks also for mentioning Dr. Rosa's interest in Chiari malformations. I'll have to remember to ask my AO chiro, Dr. Wehrenberg, who is a major researcher in these studies, about the Chiari angle, especially because Dr. Flanagan thinks I might possibly have the condition. I wonder if they'll be checking all MS patients for this problem--would be good to know!! I'll let you know what I find out from Dr. Wehrenberg. Btw, I met Dr. Rosa when he performed my adjustment last summer--he's a truly wonderful doctor.
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Re: JUGULAR VEIN COMPRESSION

Postby civickiller » Sat Feb 25, 2012 1:32 am

i cant wait for the results from this study.

HP, thanks for mentioning it to Dr Wehrenberg, feel good knowing your personally helping to finding the cause and cure for MS

i wish i lived in near NY, id participate in this study in a second
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Re: JUGULAR VEIN COMPRESSION

Postby 1eye » Tue Jun 12, 2012 3:28 pm

Cece wrote:
Neurosurgery. 2011 Aug 19. [Epub ahead of print]

Styloidogenic Jugular Venous Compression Syndrome: Diagnosis and Treatment.

Dashti SR, Nakaji P, Hu YC, Frei DF, Abla AA, Yao T, Fiorella D.

"...primary stenting is not only ineffective, it may actually exacerbate the outflow obstruction..."
How/why's that?
"Try - Just A Little Bit Harder" - Janis Joplin
CCSVI procedure Albany Aug 2010
'MS' is over - if you want it
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Re: JUGULAR VEIN COMPRESSION

Postby drsclafani » Mon Jun 18, 2012 5:26 am

Cece wrote:http://www.ncbi.nlm.nih.gov/pubmed/12227629
Med Biol Eng Comput. 2002 Jul;40(4):423-31.

Circulatory effects of internal jugular vein compression: a computer simulation study.

Bosnjak R, Kordas M.

Department of Neurosurgery, University Hospital Center, Ljubljana, Slovenia.

Abstract

The effects of compression of the internal jugular veins and the inferior vena cava are simulated using an equivalent electronic circuit, which included simulation of cardiocirculatory phenomena and special features of the cerebral circulation. Compression of the inferior vena cava resulted in a profound decrease in cardiac output (from 4.5 to 1.51min(-1)) and arterial pressure (from 140/85 to 50/35 mmHg). Compression of the internal jugular veins resulted in a negligible decrease in cardiac output and arterial pressure, with a cerebral blood flow that was slightly decreased. Cerebral capillary and internal jugular pressures were considerably increased, leading to obstruction of cerebral veins and increased pressure (from 9 to 22 mmHg) and volume (from 120 to 145 ml) of the cerebrospinal fluid (CSF). Increased cerebral capsule compliance resulted in decreased CSF pressure (from 9 to 8.5 mmHg), but CSF volume increased (from 120 to 190 ml). A small increase in brain volume (from 1,000 ml to 1,060 ml, 6% volume increase) was compensated for by an equal decrease in the volume of CSF. When brain volume was above 1,080 ml, the absorption of CSF was reduced, and its pressure increased.


and this one:
http://www.ajronline.org/content/142/2/403.full.pdf
Jugular Vein Obstruction Caused by Turning of the Head

It mentions that in a study of dural sinuses, only 57% of sinuses had free communication across all sinuses and both sides. Thus if there is one-sided obstruction, the sinus might not be the safety net that diverts blood flow easily to the other side. Sinuses are a part of the CCSVI picture.

The article also talks about compression of the jugular when you turn your head. If you turn your head to the right, the right jugular is compressed but the left remains open.


Page 405 figure 2 shows a really good image of a normal J1 segment. Anyone ever see anything like this in a PwMS?

I have not
Salvatore JA Sclafani MD
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