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neck injuries leading to jugular vein thrombosis

Posted: Fri Dec 30, 2011 3:52 pm
by Cece
http://www.ncbi.nlm.nih.gov/pubmed/20937957
Arch Neurol. 2010 Oct;67(10):1269-71.

Superficial siderosis of the central nervous system due to bilateral jugular vein thrombosis.

Yavagal DR, Geng D, Akar S, Buonanno F, Kesari S.

Source

Department of Neurosciences, Rebecca and John Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA 92093-0819, USA.

Abstract

OBJECTIVE:

To describe a novel cause of meningeal siderosis due to intermittent subarachnoid bleeding caused by chronic bilateral jugular vein thrombosis.

DESIGN:

Case report and review of literature.

PATIENT:

A 51-year-old man with a distant history of cervical injury who presented with transient aphasia in the setting of progressive cognitive decline.

INTERVENTION:

Neurological examination, magnetic resonance imaging, lumbar puncture, and angiogram.

RESULTS:

The patient had intermittent subarachnoid bleeding resulting from extensive venous collaterals in the neck and cervical spine due to chronic bilateral jugular vein thrombosis.

CONCLUSION:

Unexplained neurological deterioration and history of cervical trauma warrants diagnostic consideration of superficial siderosis and jugular vein thrombosis.
While I agree that, based on what is known about CCSVI being a condition of malformed valves or other intraluminal abnormalities or hypoplasias, this is a congenital condition, I also think that in those of us who have the congenital condition of CCSVI, if we were to get a whack on the neck and develop a jugular thrombosis, that would worsen our CCSVI.

This one describes a similar condition to what we have, with extensive venous collaterals in the neck and cervical spine and "chronic" rather than acute jugular blockages, albeit due to thrombosis instead of our typical malformed valves. But this patient suffered from intermittent subarachnoid bleeding as well, presumably as a result of the jugular blockages. Why would this happen in this patient and not in us?

"Superficial siderosis" may be an analagous condition to CCSVI. It occurs when hemosiderin is deposited in the brain due to recurrent bleeding into the cerebrospinal fluid. If indeed this is happening in CCSVI, there is precedence in superficial siderosis that hemosiderin deposited in the brain leads to neurological sequellae.

Re: neck injuries leading to jugular vein thrombosis

Posted: Sat Dec 31, 2011 3:01 am
by EJC
I wish I completely understood the latin in medical speak and it's context.

Each time you post one of these artciles Cece (which I must add is fantastic that you continue to find them), I spend more time in Google trying to understand the medical terminology and how they are relevant in this context than I do actually reading the document itself!

Anyhow - you just get this feeling that sooner or later all these perculiar conditions of the neck, head and venous systems are going to give up some onformation that starts to link them together.

I like the way your're thinking though -

Congenital CCSVI + neck trauma = Accellerated symptoms

That could be a reasonable explanation of why some get symptoms as early as their teens and others soldier on until retirement before any problems arise. Well it's another theory!

Re: neck injuries leading to jugular vein thrombosis

Posted: Sat Dec 31, 2011 11:17 am
by Cece
I don't think we know yet what all could contribute to accelerated symptoms but I agree that this could be one of them!

Some thoughts:

There are different degrees of congenital CCSVI. Both jugulars could be fully closed. Both could be partially closed. One could be wide open, but the azygous is partially closed. This could contribute to the timing of onset or type of MS.

Renal vein syndrome is a factor in some patients. Renal vein phenomenon, which is when the renal vein is compressed but no apparent symptoms, is most likely to be seen in the young and thin. (This was in some material I previously linked on renal vein syndrome.) So it might be that renal vein syndrome doesn't really kick in until we get older and, alas, heavier. This could contribute to the worsening of CCSVI and timing of onset, etc, in those patients with renal vein compression.

Immune system is undeniably involved. The neurologists' past few decades of research is not without merit in that regard, even if they never caught on to the vascular involvement. Those with a genetic tendency to have their immune systems freak out, if you will, can then expect their immune systems to freak out when called upon to deal with the damage being incurred in a CCSVI-affected CNS environment, as well as increased access due to damaged blood-brain barrier.

Different people will have different degrees of ability to create collaterals, and the strength of those collaterals. Blockages from an early age might actually result in better collaterals, as the body can take advantage of the childhood years of growth to build them. Exercise and vitamin D and sunshine might contribute to better collaterals, better blood-brain barrier, better jugulars.

Some people will have hypoplastic ascending lumbar veins. Untreatable, possibly associated with progressive MS.

Men have more elastic jugulars than women, thus potentially leading to more 'storage capacity' as the blood flow attempts to get past the blockage, and less reflux into the brain where the worst damage is done.

In a healthy person, our venous system is equipped to deal with damage or loss to a vessel. Other veins take over the flow, seemingly without consequence, although that seems to be something that has been taken for granted and not well-researched for long-term consequences. But, in a person with CCSVI, there is nothing to spare, so if additional damage occurs, our situation is worsened. We've yet to know what could be additional damage or cause additional narrowing in a person with already-existing CCSVI. Jaw misalignment, atlas misalignment, trauma to the neck, trauma to the renal vein, abdominal weight gain that compresses any of the relevant veins, weight gain in the neck, chemo, radiation, dialysis, incidental damage from venoplasty, damage due to clotting, jugular thrombosis due to ovarian hyperstimulation syndrome (something to discuss if you're considering infertility treatment, probably rare), loss of elasticity in the jugulars, and aging could all be factors that worsen our condition, and there could be factors that I've missed.

So, in short, I'd say the equation could be:
Congenital CCSVI + [many possible factors, one of which could be neck trauma] = possibility of accelerated symptoms

More unknowns and 'possibles' in my equation!
Makes me want to see Dr. Tucker's actual equations! Hope physics is as easy to learn with no background as interventional radiology of one specific condition has been! Although the credit goes to the teacher (Dr. Sclafani) for the latter seeming easy.

I just like that anyone reads the articles I dig up! A lot of times they're not directly related to CCSVI, because there's not enough research on CCSVI, but there is research on jugulars in other conditions, and you never know how it will all contribute to a global knowledge of the jugular. If we are due for a snowballing of CCSVI research in this next year, I cannot wait.

Re: neck injuries leading to jugular vein thrombosis

Posted: Sat Dec 31, 2011 12:57 pm
by MrSuccess
I also cannot wait.

Let's step back from all of the fantastic CCSVI information coming to light , and talk about MS for a minute.

Multiple Sclerosis is a term coined a long time ago. It means ' multiple scars '. These -multiple scars - were identified on examination of the brains of deceased people. There were no MRI'S [ invented in 1989] or other means .... to examine live subjects exhibiting the signs and symptoms of this suspected disease. All guesswork .... until death.

Fast forward to today. Our medical experts can now peer into our heads .... and obtain very good observations of brains. And nobody has to die first. They observe and record the size,location ,and number of .... those 'multiple scars' .... that their pioneering peers could only discover on autopsy.

Quite naturally , a fundimental question was asked .... Why are these multiple scars appearing in/on peoples brains ? To add to the puzzle .... they also found multiple scars on brains of people ..... that were deemed to have been healthy ....until death.

This very puzzling situation exists today. Present day Neurologists know this fact.


Multiple Sclerosis [ M S ] is an old discovery. How old .... can be debated. But certainly old enough to eliminate ' environmental causes' as a reason. There were plain and simple ..... no chemicals ... no food additives ..... no particles of whatever floating through the air ...... nor had man quite figured out yet .... how to pollute his water. Life was basic and simple. And still ..... doctors were recording people having the same symptoms then ...as we have today .

Looking for a common denominator. Some facts.

Fast forward to the year 2000. Medical professionals can now use sophisticated ways and means to diagnose . Methods of data collection [ computers ] expand.

It is a undisputed fact that multiple scars are found in females more so that males. As many as FOUR times in ratio.

There is a long held THEORY ..... that these ' multiple scars ' are the possible result of some form of TRAUMA induced to the neck or back of previously healthy people.

The World changes.

Not that long ago ..... it was unheard of for the fairer sex to be involved in activities such as playing sports ..... driving cars .....working outside the home ..... even voting.

You've come a long way , baby.

Today , we now have an explosion of female participation [ 1960's + ] in contact sports ,military service ..... and automobile accidents .

The connection between trauma and increased female exposure to it ....... is not lost on sharp minded collectors of data.

Some food for thought .

And MrSuccess wish's all TIMS readers ... Happy New Year.



MrSuccess

Re: neck injuries leading to jugular vein thrombosis

Posted: Sat Dec 31, 2011 1:23 pm
by Cece
MrSuccess wrote:Not that long ago ..... it was unheard of for the fairer sex to be involved in activities such as playing sports ..... driving cars .....working outside the home ..... even voting.

You've come a long way , baby.

Today , we now have an explosion of female participation [ 1960's + ] in contact sports ,military service ..... and automobile accidents .

The connection between trauma and increased female exposure to it ....... is not lost on sharp minded collectors of data.
This would actually be an argument against trauma having a role in MS. MS is predominantly a female disease, as you said. Even if females are more involved in such things as contact sports, military, and car accidents, they are still greatly outnumbered by men.

There were other articles on jugular vein thrombosis, more than one which talked about successful recanalization of the thrombosis. I can't say for certain but it seemed as if recanalization after jugular thrombosis was more likely in nonCCSVI patients than it seems to be among us. I wonder if this could be due to poor overall flow to the jugulars, flow being diverted by our prominent collaterals, damage in CCSVI patients due to overstretching of the jugulars, inadequate and untimely follow-up care, or something else.

Re: neck injuries leading to jugular vein thrombosis

Posted: Sat Dec 31, 2011 2:37 pm
by MrSuccess
No ... it is a strong argument .... FOR.

In 1960 life was certainly different for women vs. men. In high schools , first prize was often a tie clip .... in math class. I doubt your mother drove herself to judo class in 1960 .... more than likely .... your Dad did the driving .... as the family car probably had "Armstrong Steering ". Unlike today , it's common to see a tiny wisp of a thing jump out of an 18 wheeler . No doubt she can manouver that sucker as good ... if not better than any man. Improvements in mechanicals allow this.

In 1960 .... men dominated the sporting world. Today , University's must offer equal opportunity's in facility's. Are you even old enough to remember all this ? :razz:

Today's women are FULLY engaged in everything you can think of. The Military . Police Forces. Boxing. Judo. Karate. Most women work now. Many own , drive , and even maintain their own cars. In 1960 ..... this was rare.

Women are now exposed to all levels of violence that your Grandmother never had. And some things never change ....... the female is still smaller ... and more delicate in physical presentation. At least Mrs.Success is .

My information is that about 5% of people that suffer some form of trauma .... go on to become labeled as having MS. This may indeed be CCSVI ..... not MS.

Time will tell.


MrSuccess

Re: neck injuries leading to jugular vein thrombosis

Posted: Sat Dec 31, 2011 4:39 pm
by CureOrBust
MrSuccess wrote:My information is that about 5% of people that suffer some form of trauma .... go on to become labeled as having MS.
But what are the statistics for the number of people that suffer some form of trauma, that do not go on to become labelled as having MS? Statistics also have methods for calculating the confidence intervals, and it is at this point I would guess most research along these lines have failed to find a firm link.

Re: neck injuries leading to jugular vein thrombosis

Posted: Sat Dec 31, 2011 6:50 pm
by MrSuccess
95% :wink:

Even down under ... 5 + 95 = 100


MrSuccess

Re: neck injuries leading to jugular vein thrombosis

Posted: Sat Dec 31, 2011 7:38 pm
by CureOrBust
"downunder", not 100% of people suffer trauma. The maths are not that simple, unless they had a population sample of the whole world for your "5%" statistic sample pool :-B . I do not remember being asked. /:) Also using your mathematical model, the rate for MS would be at or greater than 5% for the world population? 8-X

Re: neck injuries leading to jugular vein thrombosis

Posted: Sat Dec 31, 2011 8:44 pm
by MrSuccess
'bust ... where did you get those great smilies ?

Numericals have significant importance. Yes , they can be twisted to suit at times.

The VAST MAJORITY of people that have suffered some form of injury-trauma do not present with MS symptoms .... ever.

When MS patients give their medical history ..... TRAUMA .... will only be reported in about 5/100 cases. That is significant information.

As in your case ... ' stubbed toes ' don't count. :razz:

How about ' stubbed necks or stubbed backs ? ' :idea: :wink:


MS is an old physical malady. The symptoms are the same then .... as now.
Therefore ....... modern day environmental causes ...... can be ruled OUT.

Some births are difficult . Name me one child that hasn't had their fair share of tumbles and fallen from trees or other heighths. Life has been like that for the last 100 years .... and will be for the next 100 years. I doubt anyone remembers their events.

The last 50 years for females have been one of huge advancements. I have outlined the occupations and activities they now pursue. The down side is ..... they are now subjecting themselves to high risk of injury. I include automobile crash's.

By and large ...... the female neck ..... is not able to absorb blunt force trauma.

I do hope the CCSVI investigating experts consider this ...... when collecting their data.


Let's leave no stone unturned .... in solving the mystery of MS.



MrSuccess

Re: neck injuries leading to jugular vein thrombosis

Posted: Sat Dec 31, 2011 9:49 pm
by civickiller
i think pwMS are dismissing or not remembering traumas that might cause any damage

the majority of female bodies is not built for strength and muscles leaving neck muscles weaker and more vulnerable to "traumas"

not to offend women

and while people might not present with MS, they suffer from other pains such as back pains or migraines

Re: neck injuries leading to jugular vein thrombosis

Posted: Sun Jan 01, 2012 3:14 pm
by blossom
true, i don't know of any women that play for the pittsburgh steelers. but the roll of a woman in this world was and is not a cake walk. think of childbirth alone and afterwards carrying a baby on one hip while trying to manage everyday life. these things can put a strain on the body and especially the neck and shoulders. may not be what some might think is trauma but injury is injury. there are and always were elements in a woman's life that could be a natural part of life that caused trauma.

but agreed women in the last 100 yrs. especially have joined the ranks in things that was dominated by men. and, we are built as mr. success stated.
but, look, remember the pictures of the "caveman" dragging his woman around by the hair. "lol".

women are "supposedly" the weaker species but there has always been a heavy load put on our shoulders for such sweet little cuties-----both physically and mentally.

so, i think it's an even playing field of sorts in this respect. maybe in general makeup of our bodies has a play? then again there are more women in the world than there are men they say. so gotta consider that. kinda up for grabs and thinking as to why more women than men.

Re: neck injuries leading to jugular vein thrombosis

Posted: Sun Jan 01, 2012 4:10 pm
by Cece
for what it's worth...
J Biomech. 2008;41(1):114-21. Epub 2007 Aug 13.
Head and neck anthropometry, vertebral geometry and neck strength in height-matched men and women.
Vasavada AN, Danaraj J, Siegmund GP.
Source
School of Chemical Engineering and Bioengineering, Washington State University, Pullman, WA, USA. vasavada@wsu.edu
Abstract
Women have an increased incidence of whiplash injury and neck pain compared to men. Physical and numerical models represent one avenue to explore and potentially explain these gender differences, but a valid model of the female neck does not yet exist. A fundamental question in the development of a female neck model is whether female necks are simply scaled versions of male necks, or whether there are significant inter-gender geometrical differences. The goal of this study was to quantify differences in head and neck geometry and neck strength in pairs of male and female subjects matched for standing height and neck length. Based on 14 matched pairs of men and women, we found that most head and neck anthropometric parameters were significantly smaller in females compared to males. Moreover, gender differences in a number of neck anthropometry parameters (an average of 9-16% smaller in females) were larger than differences in head anthropometry parameters (an average of 3-6% smaller in females). Female vertebrae between C3 and C7 were significantly smaller than male vertebrae in the anterior-posterior dimension (p < 0.012) but not in the medial-lateral dimension (p > 0.07). Female necks were also significantly weaker than male necks (32% weaker in flexion and 20% weaker in extension; p < 0.001), and these strength differences corresponded well to those predicted solely from the observed geometric differences. These results demonstrate that male and female necks are not geometrically similar and indicate that a female-specific model will be necessary to study gender differences in neck-related disorders.

http://www.ncbi.nlm.nih.gov/pubmed/17706225

Re: neck injuries leading to jugular vein thrombosis

Posted: Sun Jan 01, 2012 4:24 pm
by civickiller
i think theres a whole list of influential causes for injuries- population growing so will the number of ms dxed, people dont work(physical labor) as much growing up so arent developing muscles as much, people play alot more aggressively, more vehicles more accidents.

this can be tweaked for men and women situations

Re: neck injuries leading to jugular vein thrombosis

Posted: Sun Jan 01, 2012 9:34 pm
by civickiller
Cece wrote:for what it's worth...
J Biomech. 2008;41(1):114-21. Epub 2007 Aug 13.
Head and neck anthropometry, vertebral geometry and neck strength in height-matched men and women.
Vasavada AN, Danaraj J, Siegmund GP.
Source
School of Chemical Engineering and Bioengineering, Washington State University, Pullman, WA, USA. vasavada@wsu.edu
Abstract
Women have an increased incidence of whiplash injury and neck pain compared to men. Physical and numerical models represent one avenue to explore and potentially explain these gender differences, but a valid model of the female neck does not yet exist. A fundamental question in the development of a female neck model is whether female necks are simply scaled versions of male necks, or whether there are significant inter-gender geometrical differences. The goal of this study was to quantify differences in head and neck geometry and neck strength in pairs of male and female subjects matched for standing height and neck length. Based on 14 matched pairs of men and women, we found that most head and neck anthropometric parameters were significantly smaller in females compared to males. Moreover, gender differences in a number of neck anthropometry parameters (an average of 9-16% smaller in females) were larger than differences in head anthropometry parameters (an average of 3-6% smaller in females). Female vertebrae between C3 and C7 were significantly smaller than male vertebrae in the anterior-posterior dimension (p < 0.012) but not in the medial-lateral dimension (p > 0.07). Female necks were also significantly weaker than male necks (32% weaker in flexion and 20% weaker in extension; p < 0.001), and these strength differences corresponded well to those predicted solely from the observed geometric differences. These results demonstrate that male and female necks are not geometrically similar and indicate that a female-specific model will be necessary to study gender differences in neck-related disorders.

http://www.ncbi.nlm.nih.gov/pubmed/17706225
thanks for posting this, this is a good article explaining why women get MS more than men and the need for pwms to see a upper cervical Dr to see if they require this kind of care. i believe this will increase the effectiveness of ccsvi surgery