allynz wrote:
...lesions on the brain vs the spine, the neuro says the spinal ones are our real problem - do you think it makes a difference in regards to CCSVI.
There was speculation early on that jugular blockages led to brain lesions and azygous blockages led to spinal lesions. That hasn't held up. But I would still advise that you want as thorough an examination of the azygous vein as possible. The more experience the IR has, the better. IVUS is indispensible, but I don't think there are any CCSVI IRs in Australia using IVUS.
Blockages in the jugulars can also lead to impaired cerebrospinal fluid flow, which affects the spinal cord. Blockages in the jugulars could be near to MS lesions in the cervical portion of the spinal cord. Some people with PPMS have lumbar veins (small veins that drain the spine) that are abnormally small. Those cannot be treated and not every doctor checks them, but as a patient it is helpful to know if you have this or not. There is also the possibility of renal vein stenosis. Not every IR checks for renal stenosis, but it has been suggested that a blockage in the renal vein redirects considerable flow into the cerebrospinal drainage routes.
It is harder to recover from spinal lesions because plasticity and recruiting new neural routes is a part of recovery and there is not much room for new routes or recruiting in the tightly-packed spinal cord. But improved blood flow could contribute to better nutrient levels at the neurons, waste removal, and less focal hypertension. It sets the stage for healing, if healing is possible.
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