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New Paper from Zamboni, et al
Posted: Fri Jul 03, 2009 8:18 am
by cheerleader
Venous Collateral Circulation of the extracranial Cerebrospinal outflow routes....abstract on line prior to publication.
http://www.ncbi.nlm.nih.gov/pubmed/19534716
1: Curr Neurovasc Res. 2009 Aug 1. [Epub ahead of print]Links
Venous Collateral Circulation Of The Extracranial Cerebrospinal Outflow Routes.
Zamboni P, Consorti G, Galeotti R, Gianesini S, Menegatti E, Tacconi G, Carinci F.
Vascular Diseases Center, University of Ferrara, Ferrara, Italy.
zmp@unife.it.
A new nosologic vascular pattern that is defined by chronic cerebrospinal venous insufficiency (CCSVI) has been strongly associated with multiple sclerosis. The picture is characterized by significant obstacles of the main extracranial cerebrospinal veins, the jugular and the azygous system, and by the opening of substitute circles. The significance of collateral circle is still neglected. To the contrary, substitute circles are alternative pathways or vicarious venous shunts, which permit the drainage and prevent intracranial hypertension. In accordance with the pattern of obstruction, even the intracranial and the intrarachidian veins can also become substitute circles; they permit redirection of the deviated flow, piping the blood toward available venous segments outside the central nervous system. We review the complex gross and radiological anatomy of collateral circulation found activated by the means of EchoColor-Doppler and selective venography in the event of CCSVI, focusing particularly on the suboccipital cavernous sinus (SCS), the condylar venous system, the pterygoid plexus, the thyroid veins, and the emiazygous-lumbar venous anastomosis with the left renal vein.
Looks like Dr. Zamboni's team is undertaking the question we all knew would arise....but what about collateral veins? Who needs two stinkin' jugulars, anyway?
cheer
Posted: Fri Jul 03, 2009 9:33 am
by kaykayaa
I do! I do!
Posted: Fri Jul 03, 2009 10:05 am
by Ernst
Had some difficulties to understand with my poor english.. but was the main point that obstacles in veins affects to circulation so there will be "other ways" for blood to flow? Body trying to solve a problem thing?
Posted: Fri Jul 03, 2009 10:24 am
by mrhodes40
Oh man thank goodness! I agree that is exactly what he is putting out here:
The significance of collateral circle is still neglected
He means that if this is seen the importance of this is not understood or appreciated by the medical community.
which permit the drainage and prevent intracranial hypertension.
the body is doing this to prevent gross hypertension... ergo intracerebral venous hypertension would be there if the collateral veins did not do this. Hydrocephalus is such a problem.... enough said about that.
In accordance with the pattern of obstruction, even the intracranial and the intrarachidian veins can also become substitute circles; they permit redirection of the deviated flow, piping the blood toward available venous segments outside the central nervous system.
The intracranial veins are in the very deepest parts of your brain. Redirecting blood there so that the blood can get out some way is not good...
the thyroid veins
I'm starting a thread on that..............
marie
Posted: Fri Jul 03, 2009 10:29 am
by cheerleader
This paper will be addressing the problems that occur when jugular and azygos blockage results in collateral drainage. The current understanding is that the body can deal with venous blockage by finding alternate pathways to the heart. But Dr. Zamboni and his team have found that although the blood returns, these new drainage patterns cause damage in the brain and spine....what he calls CCSVI. Now his team is showing exactly how these new routes - collateral circulation- contribute to CCSVI.
Marie and I have been concerned that doctors would say to their patients.- "It's not a big deal if you have venous blockage, the body can work around it"... because that's been the standard mode of understanding. Of course, we can see in CVI in the legs that the body may work around it, but not well. And venous ulcers and pain is the result of weak collateral drainage.
Nosologic means the classification of a new disease...Dr. Zamboni's team is saying the CCSVI is a new disease model, and now they're going to prove it! whoo hoo-
cheer
Posted: Fri Jul 03, 2009 10:51 am
by Ernst
Thanks again.. now I understand this better
Posted: Fri Jul 03, 2009 10:54 am
by mrhodes40
Way to go Cheer! right on, that is the concern and this paper addresses this issue. I lay awake at night worrying about where the weak points are in terms of getting it out to people and defending the need to do so with good science. Clearly to Dr Dake the presence of collaterals is THE thing. After my surgery I tried to get them to qualtify the pressure differentials across the stenosis and they said no big deal what matters is that the collaterals disappeared....thats how we know it was a success.
marie
Posted: Sun Jul 05, 2009 11:26 am
by Loobie
Just back from camping. Man oh man, keep finding this stuff!!