That's the goal. I'm interested in CCSVI. I’ve spent a little bit of time here at TIMS, first learning that a cytokine was and all about the variations of what is a white blood cell. Then I spent (and still spend) time on bacteria and antibiotics. So you might know just exactly the level of understanding I pursue. In a nutshell, I want to understand the “big words” and I want to find a logical connection between the concepts.
So, I have tried reading about CCSVI and I’ve been slammed with new words. I understand that I don’t need to understand all of them to be here, but that’s not how I do things. I have gone through all the pages of the CCSVI post and printed up most all linked material. I intend to read all of it and understand it. I started with Chung and Hu 2008, Jugular Venous Reflux. I did not make it through the second page. Please don’t try to explain it to me just yet. I want to leave a map here for the next person. So I begin my journey of new learning with ......
Artery’s In, Sinuses Out
I have started with trying to understand how blood flows around the brain. Blood flowing through the brain doesn’t seem to work like it does elsewhere in the body. The first thing I figured out is that there’s a bunch of red lines going into the brain (from the heart) and those are called arteries. There some blue lines coming out of the brain and those are called sinuses. It’s not entirely clear what’s happening in-between, but I don’t know if that’s important. Here’s a PowerPoint that was helpful for me:
Eriksson 2007 Neuroanatomy Related to Stroke
It’s not until you get the very end of the presentation that you can read about Venous Drainage. Goes to show you how much anybody realy has cared about this topic. But, I also learned of a part called “Arachnoid Villi”. Arachnoid Villi seem to be something of an exception to what we all think of as the impenetrable blood-brain-barrier (BBB). I don’t know if these matter at all in my trying to understand CCSVI or even MS, but I guess I was very surprised to read that these things are right there letting excess spinal fluid out and into the blood system. And then, the BBB isn’t so simple either.
Does it Mater
So I was wondering where is the BBB in all this. Well at least part of it is included in the Meninges (men-in-geez), which is made up of Dura Mater, Arachnoid Mater and Pia Mater.
McCaffrey, Unit 11. Blood Supply
“Many substances present in the blood supply are unable to pass through the meninges into the cells of the central nervous system. The blood brain barrier includes two components, the blood/cerebrospinal fluid barrier and the arachnoid barrier layer.
Cerebrospinal fluid is a filtrate of blood by the choroid plexuses (capillary networks) of the ventricles which are formed by fusion of the pia mater and the ependyma (ventricular lining). In the course of this process, not all components of blood are allowed to enter the brain. According to Webster, 1999, only clear plasma passes through, leaving blood cells behind.
The arachnoid barrier layer is a part of the arachnoid meningeal layer. It is formed by tight junctions between the endothelial cells of cerebral capillaries in the arachnoid mater.”
There were some really good diagrams of the Meninges here and a very nice diagram of the Arachnoid Villus here.
Name that Vein
Going back to Zamboni, his December 2008 paper has a really nice diagram in the back that describes the 4 types of Cerebrospinal Venous Insufficiency he observed. I’m not linking to it because I’m sure you have your own copy if not several printed up. Now that I know that red means arteries and that’s outbound blood (from the heart), I can focus on the blue veins that are inbound (to the heart). Here’s a really nice webpage I printed up in color to help me understand the labels: Blood Vessels. I have identified the IVC, L-REN, Vplex, SVC, AZY, IJVr and IJVl. I still don’t know what the VVs is or some of the other unlabelled lines.
Let me just say, I start this quest with NO knowledge of how the brain is designed. These few links above, will give you a HUGE awakening about the thing between your ears. I highly recommend, if you can, print the links up in COLOR because, 1) good reference material and 2) don't know how long those links will last.
I hope you don’t mind having an ABX’er along for the ride. Ken