Clive Beggs ISNVD 2015

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

Clive Beggs ISNVD 2015

Postby Cece » Sat Mar 28, 2015 4:30 pm

https://isnvd.org/d/sites/default/files ... %20all.pdf

Blood storage within the intracranial space and its impact on cerebrospinal fluid dynamics

Clive B Beggs 1
, Simon J Shepherd 1
, Pietro Cecconi 2
and Maria Marcella Lagana 2
1. Medical Biophysics Laboratory, University of Bradford, Bradford, BD7 1DP, UK
2. Fondazione Don Carlo Gnocchi ONLUS, IRCCS S. Maria Nascente. Milan, Italy

Background: The volumetric changes that occur throughout the cardiac cycle (CC) in the various
intracranial vascular compartments are poorly understood. Although blood entering/leaving the
cranium is pulsatile, flow in the cerebral vascular bed is non-pulsatile [1], implying the transient
storage of blood.

Objective: To characterise the temporal changes in fluid volume that occur within the cranium
throughout the CC.

Methods: Neck MRI data were acquired from 14 healthy adults (age <35), using a 1.5 Tesla
scanner. Arterial, venous and cerebrospinal fluid (CSF) flow rate data acquired at the C2/C3 level
were standardized to 32 points over the CC. The relative changes in the intracranial arterial, venous
and CSF volumes were calculated by: (i) integrating the respective flow rate signals to compute the
instantaneous volumetric changes (ivc); (ii) mean centering the respective ivc signals; and (iii)
cumulating the mean centered ivc signals to yield the fluid volumetric changes in the cranium
throughout the CC.

Results: The aggregated flow rate signals for all subjects are shown in Figure 1, while Figure 2
shows the relative changes in the intracranial arterial, venous and CSF volumes. A strong inverse
relationship exists between the arterial and venous volumetric signals (r = -0.844, p<0.001). As the
intracranial arterial blood volume decreases to a minimum during diastole, so blood is stored in the
intracranial venous compartments. This coincides with the period when the intracranial CSF volume
increases. Only when the intracranial CSF volume peaks and starts to decrease, is the venous blood
stored in the cranium allowed to discharge.

Conclusions: The behavior of the venous pulse is controlled by volumetric changes within the
cranium in a process that is mediated by the CSF. This finding supports the hypothesis that CSF
interacts with the cortical bridging veins to facilitate the storage of venous blood during diastole
[2,3].

Figure 1. Aggregated fluid flow rates. Figure 2. Relative intracranial fluid volumes.
References: [1] Bateman GA. Neuroradiology 2002, 44:740–748; [2] Luce JM, et al. J Ap

Not sure I understand this one.
Cece
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Re: Clive Beggs ISNVD 2015

Postby Cece » Sat Mar 28, 2015 5:04 pm

https://twitter.com/ZHaskal/status/5817 ... 04/photo/1
Ziv Haskal MD ‏@ZHaskal

Dr Clive Beggs:remarkable modeling correlation of CSF & Jug vein curves,reinforcing inextricable regulatory linkage

Follow the twitter link to see Dr. Haskal's picture of Dr. Begg's graph in his presentation. The two curves greatly overlap.
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Re: Clive Beggs ISNVD 2015

Postby cheerleader » Sun Mar 29, 2015 10:17 am

YAY! Cece popped in!
Thanks for the twitter links, have retweeted stuff @joanbeal
Lots of GREAT science being presented at ISNVD 2015---more basic findings, but as all of the researchers have explained, we have to build from the bottom up. Showing the basic brain science and mechanisms behind CCSVI is essential. CSF and venous return are inextricably linked via venous pulse.

What Clive Beggs is doing is remarkable----he is showing how the intracranial spaces store blood as it is linked to the discharge of CSF. CCSVI/MS is like what we see happen in normal pressure hydrocephalus (NPH).
As the intracranial arterial blood volume decreases to a minimum during diastole, so blood is stored in the
intracranial venous compartments. This coincides with the period when the intracranial CSF volume increases. Only when the intracranial CSF volume peaks and starts to decrease, is the venous blood stored in the cranium allowed to discharge.


Blood don't leave the head, until CSF volume begins to decrease....but if CSF pressure ain't decreasing...flow stagnates. It's a bad cycle.

Dr. Juurlink explains more about this in his new publication, available for free here. Consider it a one/two punch in CCSVI basic science. So thankful we have these two great minds working together!!!


In this paper I outline the commonalities between idiopathic normal pressure hydrocephalus and multiple sclerosis. These include decreased intracranial compliance as evidenced by increased cerebrospinal fluid volume and velocity of cerebrospinal fluid flow through the cerebral aqueduct; increased ventricular volume; periventricular demyelination lesions; increase in size of Virchow-Robin spaces; presence of Hakim’s triad comprised of locomotory disabilities, cognitive problems and bladder control problems. Furthermore, multiple sclerosis is associated with decreased arterial compliance. These are all suggestive that there is a pulse wave encephalopathy component to multiple sclerosis. There are enough resemblances between normal pressure hydrocephalus and multiple sclerosis to warrant further investigation. Whether decreases in intracranial compliance is a consequence of multiple sclerosis or is a causal factor is unknown. Effective therapies can only be developed when the etiology of the disease is understood. - See more at:

http://www.eurekaselect.com/129386/arti ... RO1yX.dpuf
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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Re: Clive Beggs ISNVD 2015

Postby Cece » Mon Mar 30, 2015 6:51 pm

cheerleader wrote:YAY! Cece popped in!

I was out of town earlier this month for ten days with no computer access -- we did a civil rights road trip down to Memphis. We stopped at Slave Haven, a stop on the underground railroad, where a German immigrant built his house two blocks from the Mississippi specifically with a cellar to hide escaping slaves. Then we did the National Civil Rights Institute, which incorporates the Lorraine Motel, and has a Rosa Parks bus and a sit-in lunch counter. We saw a Blytheville historic greyhound station, which was part of the Great Migration to the north, and we hit Abraham Lincoln's presidential museum on the way home. It made me happy to be a parent to be able to share all of this with the kids and say, yes, there is darkness and injustice, and there is also all this activism.

Lots of GREAT science being presented at ISNVD 2015---more basic findings, but as all of the researchers have explained, we have to build from the bottom up. Showing the basic brain science and mechanisms behind CCSVI is essential. CSF and venous return are inextricably linked via venous pulse.

Yes - basic science is being emphasized - I am not sure what to think about that! I understand the need for foundational research but I also am impatient.
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