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Chronic cerebrospinal venous insufficiency in amyotrophic lateral sclerosis

Grozdinski L. 1, Petrov I. 2, Iloska M. 1

1 Angiology and Phlebology Sector, Clinic of Cardiology and Angiology, Tokuda Hospital, Sofia, Bulgaria;
2 Clinic of Cardiology and Angiology, Tokuda Hospital, Sofia, Bulgaria

Aim. CCSVI probably is not only a risk factor for development of MS, but it is the basic ethiopathogenetical factor. The dysfunction of the blood brain barrier (BBB) appeared as a result of CCSVI can also be one of the main reasons for triggering of neurodegenerative or autoimmune processes in MS. Following this hypothesis we can assume that CCSVI is the main ethiopathogenetic factor in other neurodegenerative diseases such as amyotrophic lateral sclerosis (ALS). Up to this moment the literature has no data for Doppler or Venography examination for CCSVI in patients with ASL. The aim of this research is screening of ALS patients for CCSVI using EchoDoppler and venography.

Methods. Seven patients with ALS were examined.

Results. The patients diagnose was confirmed based on clinical symptoms and electromyography. Both jugular vein (draining the blood from the brain) and the azygos vein (draining the blood from the spinal cord) were examined by EchoDoppler and venography. In all of the patients with ALS CCSVI was determined- severe stenosis in jugular veins. In five of the patients was determined severe stenosis in the azygos vein. In all of our patients endovascular therapy was performed- balloon dilatation of jugular and azygos vein with good angiographic result- normal blood flow and diameter of the veins.

Conclusion. The discovery of CCSVI in seven patients with ALS is probably not a coincidence and raises the necessity of conduction of a systematic research for CCSVI in of patients with ALS.

language: English

•About twenty percent of people with ALS live five years or more and up to ten percent will survive more than ten years and five percent will live 20 years. There are people in whom ALS has stopped progressing and a small number of people in whom the symptoms of ALS reversed.

Probably not a coincidence.

Dr. Dake looked at CCSVI in an ALS patient back in 2009. He treated the patient, but the decline continued. Neuronal loss did not stop--this is due to Wallerian degeneration, and a continuation of programmed cell death. Like a forest fire which grows out of control, the message to die is passed from neuron to neuron. Perhaps prevention and early intervention might stop the disease process. I still have a dream that someday cerebral blood flow will be routinely tested in chlidren and volume in and out will be part of a yearly physical exam, like blood pressure and blood sugar. Someday.
cheer

How do you check cerebral blood flow reliably without and invasive test?
My dr is suggesting I have a PET scan??? Does anyone know how this works and what info it gives??? (I have had many MRV's which don't give enough info as well as CT scans)
Thanks

Positron emission tomography (PET) is capable of providing in vivo quantitative measures of CBF and has evolved to be considered the gold standard for studying cerebral hemodynamics. However, PET imaging involves the injection of radioactive tracers, which limits its repeatability and application in healthy volunteers. Among other limitations are low temporal and spatial resolution, low signal-to-noise ratio (SNR), as well as the requirement for a cyclotron. Thus, magnetic resonance (MR) perfusion imaging, being widely available and having relatively high spatial and temporal resolution, is increasingly seen as an attractive alternative to PET.