This Is MS Multiple Sclerosis Community: Knowledge & Support

One of the terms we will hear often in the discussion of CCSVI is "collateral veins." I thought it was important to start a thread regarding how these veins function in jugular and azygos blockage.



We saw several small collateral veins surrounding Jeff's left jugular vein. His left jugular was 100% occluded, and these smaller spidery veins were trying to get his blood around the blockage. Some doctors will claim that collateral veins provide sufficient drainage to an area, and that jugular vein blockage will be dealt with by the body. Be prepared to hear this when discussing jugular vein stenosis. However collateral veins are not able to transit the blood back to the heart as efficiently as the original parent vein. They are fragile and prone to distension and leakage. This can be seen by the eye in chronic venous insufficiency in the leg, where red blood cells and fluid are deposited into the tissue by overwhelmed collateral drainage veins.

Once Jeff's left jugular vein was opened, these small over-stressed veins became invisible. The stented and working jugular removed any issues of reflux into the brain, as well as any leakage into the surrounding tissue of his neck. Jeff has a large lesion on his cervical spine where this collateral drainage was occurring. It will be interesting to see if the lesion shows signs of healing, now that the leakage in this area has been removed.

Since the azygos vein runs parallel to the spine, it is easy to understand how collateral veins (which would form along the spine to circumvent blockage in that area) could easily leak into the spinal column and cause lesions.

Collateral veins do provide a means to get deoxygenated blood back to the heart...however they can lead to reflux and fluid deposition. If a doctor tells you that you don't need a functioning jugular or azygos vein, and that collateral drainage should be sufficient, you need to understand why they are wrong. This will be one of many arguments raised against CCSVI. Be prepared...
cheer

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Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
dual stents placed 5/09
CCSVI in MS

Boy I am glad you posted this; it is absolutely 100% true. I had collateral veins as well.

And it IS thought that such things as collateral circulation and the body using the accessory veins, meaing the system being able to re route to the vertebrals when the jugs are blocked, means that this alternate drainage is adequate. I have even seen papers that claim a blocked jugular is not a problem at all----

---or so they think if it got blocked last week in a surgery and they check the patient this week. "Wow look at the the vertebrals, they are distended taking up the load, the drainage is adequate, Success!!" Who knows if such a person develops MS later in life. They do not follow up for 15 years to see. And THAT is the problem.

Yesterday I had to get a CT scan of my abdomen and I told the radiologist I had jugular stents.....he said you mean carotid no one puts stents in jugulars. I said no jugular, he got a very smug and arrogant look on his face and briskly moved on, clearly "knowing", in his own mind, what he thought must be true.

This just demonstrates how well understood this is thought to be.

Balance people like that with people like my GP, who is very excited by this new idea and is actually telling her other MSers about it based on my experience. She has no trouble at all seeing that blocking the jugulars might over time cause MS lesions in the same way such a thing causes stasis ulcers, but she has no ax to grind and not reputation to defend with regards to the old idea. She is just on patient's sides.

You have to think it possible to understand CCSVI, because otherwise you have "contempt prior to investigation" an intellectual crime perpetrated by people who have a lot of education.... they assume because they know so much that they have a right to reject a new idea without really looking into it. That is a big problem for new and revolutionary ideas.

We will definitely see people arguing that it is not a problem to have an alternate route for the blood flow. If anyone knows a person with MS who had a blockage os such a type long ago (ie I had cancer 20 years ago and the central IV damaged my jugular and then I got MS 10 years later....what a bummer) Such a person's development of MS would greatly support this model being causitive... but such people often do not live long lives.

Sou had some kind of neck tumor early in life, I wonder if his situation makes this case at all?

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I'm not offering medical advice, I am just a patient too! Talk to your doctor about what is best for you...
http://www.thisisms.com/ftopic-7318-0.html This is my regimen thread
http://www.ccsvibook.com Read my book published by McFarland Health topics

Very interesting and it is good to be forearmed.

I don't have any visible MS lesions. Symptoms started 2 yrs ago. But I do have a syrinx in my spinal cord T7-T9. This is called syringomyelia, abbreviated SM. A syrinx is a fluid-filled cavity in the spinal cord, usually a dilation of the central canal. Given the nature of the lesions, it's easy to see why SM and MS cause many of the same symptoms.

Syringomyelia:
http://www.asap.org/syringomyelia.html

I've been tested for all the known causes of this condition by a leading expert in the world, mine is idiopathic (unknown cause).

When my spinal tap indicated MS, I found this study, which found a syrinx in the spinal cord of 4.5% of 202 MS patients::
http://brain.oxfordjournals.org/cgi/content/abstract/131/7/1776

Now, I think it's possible that leakage from my blocked azygous could be causing the syrinx, and thus the first MRI-visible sign of my MS.

If azygous leakage isn't causing the SM directly, then perhaps it is causing an unseen lesion that is then responsible for the accumulation of fluid in the syrinx.

I don't know why I'm spouting all this other than so all of you will know about this possible connection to the SM condition, which you've probably never heard of. It's possible that my situation could be direct evidence of the azygous involvement, although the leading experts on SM have never posited such a connection that I can find. In any event, 95% of my symptoms are spinal cord issues and most of those correlate to the level of the SM lesion in my thoracic spine.

Now, this article is really intriguing (to me), I may have to pay to read it:
"Thoracic syringomyelia and suspected multiple sclerosis: Cause and effect or coincidence?"
http://www.neurology.org/cgi/content/citation/63/1/185

Rokkit

Questions for those who had jugular stenosis and could see the collateral veins attempting to provide drainage. Where were the collateral veins located in relation to your jaw, face, neck, ear and did they appear to be shallow or deep in relation to your skin? Were they close to the facial vein?

I know this is a strange set of questions to ask but I am supposed to have some laser work done on my face to deal with another medical issue and I worry the laser could inadvertantly damage the collateral veins if they happen to be just under the skin and located on the side of the face/jaw and/or near the front of the ear. I certainly don't want to complicate drainage issues while I eagerly watch and wait for further findings about CCSVI.

I also wanted to thank all of you who have so bravely blazed the trail and have undergone this surgery. Your posts are encouraging and exciting!

"One small step for man, one giant step for mankind"

Thanks.
Waken

Welcome, Waken-
I think you need to discuss this with the laser doc. Questions would be: can this laser damage surface veins? Is it a cauterizing laser, or just a superficial laser? (ie: The hair removing/facial lasers are just superficial, and wouldn't harm veins...but you need to speak with the doc.)

The area of collateral drainage is different in every MSer, so it's hard to know where yours might be without an MRV. There are no cut and dry anatomical pics to give you....the only constant is that every MSer has reflux and stenosis in the jugulars and/or azygos veins- and collateral veins develop in the affected "area".

hope this helps a bit...
cheer

_________________
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
dual stents placed 5/09
CCSVI in MS