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Franz replied to my link that I sent;
Franz Schelling; The recommendation of IVUS is fine. As for the IJV valves: Please ask a pathologist or anatomist to show you how they commonly look and work like!

Thanks Franz, always great to hear from some one in the know!
;)
Nigel

Anonymoose wrote:I wonder if his tinnitus was pulsatile...pulsing with the vibration.

Isn't pulsatile tinnitus because of rapid blood flow through the jugular bulb? Jugular bulb is close to the ear but jugular valve leaflets are on the far side of the neck from the ear.

This is an interesting article imo, because the similar treatment to that of Team Arata is performed and dysautonomia is not mentioned, the outcomes are similar or better in this trial than the unsubstantiated anecdotals of the Team Arata work of recent times.
Why does one group attribute or label the difference as dysautonomia treatment and the other not?
Is it because the IR either does or doesn't have dysautonomia personally?
"Results: There were no postoperative complications. Colour Doppler ultrasonography showed significant improvement in cross-sectional area parameters (P < 0.05) and significant decrease in confluence velocity values (P < 0.05). Postoperative gradient pressure decreased, in internal jugular vein (IJV) significantly (P < 0.05). Re-stenosis appeared in 5.3% of patients. EDSS score was significantly improved (P < 0.01) and about half of patients reported significant or mild improvement in disease status and none of them worsening of symptoms.

Conclusion: Endovascular treatment of the IJV and azygous veins in patients with CCSVI and MS is a safe procedure with no post-procedural complications followed by significant improvement of IJV flow haemodynamic parameters and decrease in the EDSS score. Whether CCSVI percutaneous treatment might affect clinical improvement in patients suffering from MS is yet to be seen after completion of major multicentric clinical trials, still it seems like that this procedure is not negligible."
"http://phleb.rsmjournals.com/content/ea ... 6.abstract

;)
Nigel

NZer1 wrote:When we hear the term valve leaflet thickening is that proven? Is it also possible what we are seeing is the valve oscillation and the doppler and IVUS are working at a different frequency and make the moving leaves look thickened?

My left jugular had one of the immobilized leaflets.

DrCumming wrote:CeCe's follow up US shows a really nice change in the appearance of the valves.

Here is the pre procedure US



Notice the valve leaflet. This was fixed in position.

Here is the follow up US post ballooning



Leaflet is no longer visible.

Looks great!

I'll be picky here Cece and say that we are looking at 1 dimensional still photos and making assumptions over time as to what has changed.
I personally need more info about the changes and why?
;)
Nigel

Just saw the valve leaflet stuff and tinitis stuff for the first time last night. We are Canadian. My wife (doesn't have diagnosed ms) but has all the same symptoms, she was in pretty fast decline this summer, the balloon angioplasty is banned in Canada and we went down to California to Dr Arata and she got massive symptom relief. The nearest thing to a miracle I have ever seen! But I don't think the underlieing illness has gone away and what causes these symptoms in the first place? And as the disease advances, what causes the lesions? So, after talking to Dr Arata, He told me that Jade's heart does not speed up when she takes exercise, etc. I made up a theory that the valves in the ms patients jujular slam shut at very regular intervals and every time they do they transmit a "signal" or "wave" or "pulse of energy" up through the jugular into the head. Because this series of waves is regular, they end up on the same "beach" of capillaries and small veins all day everyday. This daily and nightly pounding will eventually break the blood vein barrier in specific places. I contacted Dr Schelling and he says it has merit and should be investigated. I also read Dr Schelling's book online and his description of how the lesions develop with tiny areas of "mechanical damage" could be atributed to waves in a pipe coming together from two or more different places and either amplifying to give a big pressure increase or hitting at the troughs to get a large pressure drop. I have found other info to support the idea too.

Your theory sounds a lot like the 'focal hypertension' theory. Although the valves in CCSVI are not likely to be slamming shut, because they are often immobilized, and neither opening nor shutting but just sitting there blocking the flow, there is still reflux and retrograde flow that causes pressure to increase upstream especially when an incoming wave meets a returning wave and, at that point, the pressure of the two waves combines. Focal hypertension is theorized to be able to damage the blood-brain barrier directly and to impair the transfer of nutrients across the blood-brain barrier. Treating the CCSVI will stop this (hopefully) but any damage that has already occurred may remain, and there may be 'wallerian degeneration' type processes in play that means neurons will continue to deteriorate because of the previous damage.

Don't forget about the involvement of the autonomic nervous system. It can control things such as the heart speeding up when exercising. Other people have reported autonomic nervous system improvements after ccsvi angioplasty too. Sweating is one of them.

Near miracle symptom relief is not just a good thing in itself, but a good sign that there may be additional healing and improvements over the next year. Congrats to your wife.

My 7 May 2013 procedure involved reaching the left side of the C1 Atlas vertebra. The neurosurgeon found two major problems located there. First, there was a large "half-moon" shaped bone growth that was compressing both the IJV and the vagus nerve [they are adjacent to each other, along with the carotid artery]. This bone growth was a result of a severe fall in 1990, and has been growing steadily over the years. Second, the neurosurgeon found scar tissue completely surrounding the IJV that was tethered to it. The excess bone growth was removed with a diamond drill. The scar tissue was also removed. The length of the stenosis was about two inches long, and appeared to extend up to the vascular foramen [nicknamed "sitting duck" opening in the base of the skull]. The throat surgeon then closed up the site.

The immediate benefit was that the terrible "pins and needles" sensation in my left hand disappeared-complete and immediate relief. This symptom improvement has been maintained. I attribute this particular improvement to the release of pressure against the vagus nerve.

Later, a venoplasty attempt was made on the left side to open up the veins. All previous procedures had failed-no one was able even to partially open the stenosis on the left side.

The neurosurgeon was able to quickly open up the stenosis the upper IJV with no difficulty. However when he advanced the cathier further up, he found that the left sigmoid sinus was almost completely closed. He attempted to balloon it open but was only able to get it about 20% open. Later he explained he had used a small diameter balloon because this was inside my skull and wanted to be cautious.

Even with this small opening, post procedure my blood pressure dropped 40 points [systolic], and the excessive swelling in my feet shrank about 50%. The 24/7 tinnitus in my left side completely disappeared and was reduced by 90% on the right hand side. I had forgotten what silence was like!

Unfortunately, these importments only lasted for a few days.

Later in October, I will undergo the same procedure but this time on the right hand side. 3D CT spans seem to indicate that the right sigmoid sinus is open, so I am hopeful that the right hand side can be completely opened up. If this procedure is successful, I will undergo yet another venoplasty to open up the right side IJV.

Summary, accidents can cause bone growth and scarring which causes stenosis. And stenosis causes all kinds of problems.

ETA: As far as I know, this is the first time anyone has undergone general surgery to remove bone spurs and scar tissue causing venous stenosis. It was the first time this medical college has done this procedure for this reason. I am wondering how many other MS'er's with primary progressive also had an accident prior to the first manifestation of symptoms? Other cases with hints of something wrong further upstream in the IJV's?

Donnchadh

on the subject of the vagus nerve

Vagus nerve stimulation during rehabilitative training improves forelimb strength following ischemic stroke

N. KhodaparastCorresponding author contact information, E-mail the corresponding author, S.A. Hays, A.M. Sloan, D.R. Hulsey, A. Ruiz, M. Pantoja, R.L. Rennaker II, M.P. Kilgard
The University of Texas at Dallas, School of Behavioral Brain Sciences, 800 West Campbell Road, GR41, Richardson, TX 75080-3021, USA

Highlights
•
Evaluate VNS-paired movement to restore motor function after ischemic brain damage
•
Forelimb function fully recovered when VNS was delivered during rehabilitation.
•
Motor rehabilitation without VNS failed to fully restore normal function.

Abstract
Upper limb impairment is a common debilitating consequence of ischemic stroke. Physical rehabilitation after stroke enhances neuroplasticity and improves limb function, but does not typically restore normal movement. We have recently developed a novel method that uses vagus nerve stimulation (VNS) paired with forelimb movements to drive specific, long-lasting map plasticity in rat primary motor cortex. Here we report that VNS paired with rehabilitative training can enhance recovery of forelimb force generation following infarction of primary motor cortex in rats. Quantitative measures of forelimb function returned to pre-lesion levels when VNS was delivered during rehab training. Intensive rehab training without VNS failed to restore function back to pre-lesion levels. Animals that received VNS during rehab improved twice as much as rats that received the same rehabilitation without VNS. VNS delivered during physical rehabilitation represents a novel method that may provide long-lasting benefits towards stroke recovery.

http://www.sciencedirect.com/science/ar ... 6113002234