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If SSS thrombosis pressure>ccsvi pressure, why...

Posted: Thu May 16, 2013 4:02 pm
by Anonymoose
Why don't people with SSS thrombosis have the same (or worse) MSy symptoms and MRI lesions?
http://dura.stanford.edu/Articles/Stam_NEJM05.pdf
It seems like they have very few brain stem related symptoms. I guess if the pressure is so great that it must be treated immediately, that would explain the lack of lesions. There isn't enough time for them to develop. Reflux might not be an issue too. But it seems like they should have cranial nerve dysfunction (questionable assumption?) from increased csf volume/pressure like MSers with ccsvi.

Could there be an anatomical difference making csf pressure greater in brain stem area of people with ms? Doesn't seem like something like that would be missed. But what else could explain the difference in symptoms? Maybe csf pressure isn't such a big deal in ms ccsviers?

Also interesting in that paper is the list of causes of SSS thrombosis, including birth control pills, pregnancy and childbirth, and infection.

(Female to male ratio for SSS thrombosis has followed the course of the ms ratio)

Re: If SSS thrombosis pressure>ccsvi pressure, why...

Posted: Fri May 17, 2013 7:43 am
by cheerleader
All great questions, Anonymoose!
My guess would be that MS lesions take a long time to develop, and the hypertension would need to be ongoing. A more chronic, low-level condition. Thrombosis events tend to be diagnosed more quickly, before lesions would be able to develop. But that's just a guess.

Another interesting correlation is idiopathic intracranial hypertension (pseudotumor cerebri), which does not require thrombosis to create problems. It occurs most frequently in young, overweight women. There is a correlation to birth control pills, too. The symptoms associated with this condition are all symptoms my husband had: headache, swollen optic disc, blurred vision, pulsatile tinnitus. There is a narrowing of the transverse sinus associated with this condition, and endovascular stenting is one of the treatments. It worked for Jeff.
Some people may be predisposed to IIH because of being born with a narrowed vein that drains blood from the brain; a condition that was in place since birth.
http://www.hopkinsmedicine.org/neurolog ... nsion.html

Here are some cases where IIH and MS were found together---demyelinating lesions in people with IIH---
Coincidence? Or under researched correlation?
http://cdmbuntu.lib.utah.edu/utils/getf ... ame/82.pdf
http://www.webmedcentral.com/article_view/2544
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC504474/

cheer

Re: If SSS thrombosis pressure>ccsvi pressure, why...

Posted: Fri May 17, 2013 3:26 pm
by Anonymoose
Cheer,
The iih comparison is a good one. It just occurred to me that I might have csf leakage (nose and ears). Maybe that's why I don't have ccsvi symptoms? My possible small leaks usually keep pressure in check?

I had read of a theory that lesions might be caused by high csf pressure breaking the bbb and causing lesions. The relapses would correspond with intermittent pressure spikes? Just alternate idea of how ccsvi might cause lesions.

I'm not sure I would want to give up leaks. Meningitis or brainstem symptoms or ccsvi PTA? Suddenly roto-rooting seems a little more attractive today. Maybe I'll try AO first.