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Int Angiol. 2010 Apr;29(2):183-8.

Hemodynamic patterns of chronic cerebrospinal venous insufficiency in multiple sclerosis. Correlation with symptoms at onset and clinical course.
Bartolomei I, Salvi F, Galeotti R, Salviato E, Alcanterini M, Menegatti E, Mascalchi M, Zamboni P.

Center for Rare and Neuroimmunitary Diseases, Department of Neurological Science, Bellaria Hospital, Bologna, Italy - fabrizio.salvi@gmail.com.

AIM: Chronic cerebrospinal venous insufficiency (CCSVI) is associated with multiple sclerosis (MS). CCSVI is detected by transcranial and extracranial color-Doppler high-resolution examination (TCCS-ECD) and venography that permit to identify five types of venous malformations and four major (A-D) hemodynamic patterns of anomalous extracranial-extravertebral venous outflow. We investigated possible correlation between such hemodynamic patterns and both the symptoms at onset and clinical course in patients with MS and CCSVI. METHODS: TCCS-ECD, selective venography and clinical records of 65 patients affected by definite MS and CCSVI were reviewed. RESULTS: The four hemodynamic patterns of CCSVI were unevenly (P<0.0001) distributed with respect to the types of clinical presentation and course. In particular the Type A or B patterns were common in patients with onset of optic neuritis, but rare in patients presenting with spinal cord symptoms who typically showed a type D pattern. As well, the type A or type B hemodynamic were more common in patients with relapsing remitting course than in patients with secondary progressive course and rare in patients with primary progressive course. The C hemodynamic pattern was not observed in patients with primary progressive course who showed a remarkable prevalence of the type D pattern. CONCLUSION: The distribution of venous malformations and the resulting hemodynamic pattern show correlation with symptoms at onset and clinical course in patients with MS and CCSVI.

PMID: 20351674 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/20351674

Thanks for posting this. Does anyone have information on what the four types of outflow patterns are?

In particular the Type A or B patterns were common in patients with onset of optic neuritis, but rare in patients presenting with spinal cord symptoms who typically showed a type D pattern. As well, the type A or type B hemodynamic were more common in patients with relapsing remitting course than in patients with secondary progressive course and rare in patients with primary progressive course. The C hemodynamic pattern was not observed in patients with primary progressive course who showed a remarkable prevalence of the type D pattern. CONCLUSION: The distribution of venous malformations and the resulting hemodynamic pattern show correlation with symptoms at onset and clinical course in patients with MS and CCSVI.

wow there are now sevel papers that show a correlation between ms severity and ccsvi severity. The question is will someone just diagnosed with ms show severe ccsvi if they're heading for PPMS? I guess just the fact that people like that aren't showing up in these studies is a bad sign.

It points to a progressive ccsvi, plastic and changing, that could even be caused by ms.

Interesting--just from the anecdotal info posted by us here at TIMS you can see that those with optic neuritis are usually Relapsing remitting, and differ from the PP--
seems info coming in fast for us to see why, and what to do

When you guys say optic neuritis, you do mean nystagamus right?

I'm not sure what the answer is to your question Daisy3, but one of my husband's first symptoms was internuclear something - the phenomenon where both eyes don't track something at the same time. I'm assuming that is different than optic neuritis and nystagamus.

I wanted to mention that PPMS isn't always severe MS. My husband was diagnosed with PPMS in 1997 and only started using a cane about 6 weeks ago.

just a quick question. is ON indicative of RR?