CCSVI and CCVBP

[uprightdoc]

Hi Lora, It's hard to say with so little information. I base my herbs on thorough case history and physical examination. My intuition tells me that there is nothing weak about a lady who rides horses in Montana, cracks her skull and continues to ride. Your picture shows good chi. I doubt you are the cold type and you don't appear to be dry or damp in the photo. You smoked for years however and you took BC pills. Nicotine is a vasoconstrictor and it is drying to the blood, lungs and skin. BC pills likewise can cause long term damage to blood vessels. My guess is that the weather tends to be dry in the mountains of Montana, especially in winter. Fingertips are distal and very small so a little damage can cause problems. I believe you need something to vitalize the blood. Vitalization herbs move blood and break up stagnancy like bruises. Peony is a classic for stagnancy but there are many depending on the individual's history and exam findings. Ginseng also vitalizes the blood and its good for the lungs and moisturizes. But I wouldn't recommend anything without doing a complete review of you MS signs and symptoms and what meds you are on etc..

[uprightdoc]

Mark, Great pictures. I have no idea what you are talking about as to how you digitized them and put them in a folder on your TV.

The S curve in your spine running through the shoulder girdle deforms the thoracic outlet tunnels which I discussed regarding Fernando's curvature problems. Interesting there was a surgeon recently, I think it was in Argentina, who repaired a TOS and it ended up curing the patient's Parkinson's symtpoms.

[avantitech]

I do not want to get into any peeing matches (actually, I do, but I don't have the time or energy), but Doc Flanagan was invited here, and is presenting his point of view. I write all the time "in my view"," in my opinion", etc., and so do most. An hypothesis is presumed from that preamble. The propositions are always open for debate, but why trot out hyperbole such as 'Trust me. I'm a doctor'. I have read of Dr. Flanagan's hypothesis long before it appeared here on TiMS, and nowhere has he suggested to trust him because he is a doctor. If what he puts forth rings true to an individual, they can pursue it. Obviously, costumesnational has found something in it, and others too, perhaps. It rings true as part of the puzzle of "MS" for me (disclaimer: I only have para-medic training and a freaking curiosity for ideas). Maybe it does not for others. I also believe that chronic bacterial infection plays a part, and that an infinite universe means infinite possibility. Invite me to a forum, and I might discuss it (with no authority, or conviction).

If you disagree with Dr. Flanagan's hypothesis, refute it eloquently and understandably, or STFU. Are you a Doctor of Medicine? On what authority do you assault a genuine idea? Have you read Dr. Flanagan's book? (you can probably read it for free at the library, and excerpts on his website)

C'mon, it's Spring in Australia. Cheer up.

My response is:

Firstly that

"it's enough for me to ring the alarm bell with healthy scepticism"

and the rest ....

"I'll just leave to your fertile imagination."

http://uprightdoctor.wordpress.com/ferr ... vi-battle/

[uprightdoc]

One of you asked for the basic thesis of my book. The thesis is that there is a myriad of inherited and acquired types of disorders and degenerative conditions of the spine, especially the upper cervical spine and base of the skull that can disrupt the venous drainage system resulting in chronic edema, ischemia and normal pressure hydrocephalus. These conditions can in turn initiate a cascade of neurodegenerative processes, such as the glutamate cascade, and subsequent diseases. Upright posture predisposes humans to neurodegenerative diseases. It has to do with the unique design of the skull, spine and circulatory system of the brain due to upright posture.

Actually "venous back pressure" is not a new term. I have been discussing it for over twenty-five years. In fact, one of the chapters in the book is called Acute versus Chronc Back Pressure. Blockage of the dural sinuses as a cause of normal pressure hydrocephalus is not new either. Researchers have considered it for decades but could never find the source of the blockage. But they never looked outside the skull. The role of the vertebral veins in upright posture is not my idea either. It comes from physical anthropology. I have forensic evidence of craniosynostosis that resulted in malformed jugular foramen and vertebral vein outlets that is sitting on my desk in front of me at the moment as I write.

I am very busy at this time woring on a new website to complement and expand the blog. I hope to make available PDF copies of my old papers going back to 1987 availble on the website. The papers will include all my sources and citations.

[dania]

Dr Flanagan I have been suffering with chronic edema, which disappeared 5 hours after I had the Liberation procedure. But unfortunately the improvements only lasted a week and all my symptoms returned.
Over the last few years as my MS has progressed, I noticed I have to keep my head tilted upwards (looking at the ceiling) to be able to do anything. If I tilt my head down I cannot lift my foot off the ground. It is like a light switch being turned off, tilting my head down. Any thoughts?

[costumenastional]

Dear Doctor Flanagan,

what do you think may have caused my optic neuritis? Even though the condition in my neck is obviously bad, i really think that the immune system is involved. It's really hard not to speculate that others may have subluxations but they will never suffer from MS.
I realize this is kind of generic but wouldn't you say that there is probably something concerning MS patients different than healthy population appart from CCSVI and trauma? A genetic predisposition maybe?

I would love to think your opinion about this one.

Also i have another important question which i didn't have the time to ask Dr Flanagan yet:

From my x ray, Dr Koontz told me that my Atlas is missaligned too. What about C3, C4... Is it possible for one vertebrae to be like my Axis is while the ones right below to be in position?
What your experience has tought you?

Have a nice Sunday.

[uprightdoc]

Many of you have reported feeling better, or worse, depending on which way you tilt your head forward or backward, or even after a shoe lift. That was one smart doctor. I took 14x36 films on scoliosis patients all the time. I was alos an adocate of Dr. Fred Barge methods and likewise used heels lifts in curvature cases.

Curvature problems and misalignments traction the cord and brainstem and pull it up against the hard bones of the foramen magnum, such as in Chiari malformations, and against the bones of spinal canal in scoliosis. Tilting your head backwards releases the tension. Lehermitte's sign is performed by hyperflexing the cervical spine chin toward the chest which puts extreme traction on the cord. According to Schelling extreme traction type forces cause myelin to plain old snap. I will be covering it in the next post.

I haven't covered the posterior fossa yet and the olfactory and optic nerve are higher up in the middle fossa. Jumping ahead, in brief, it is my opinion that optic neuritis is caused by compression of the optic nerve against the base of the middle fossa but there are other issues related to chronic edema and ischemia as well. Long-term pressure, edema and ischemia will damage the optic nerve.

The fourth chapter of my book is called NPH and Narrow Angle Glaucoma. Narrow angle glaucoma is caused by venous drainage problems in the eye due to stenosis of the iridocorneal angle that can cause blindness. NPH is caused by drainage problems in the brain that can lead to dementia. I figured out a connection many years ago. Recent studies connected glaucoma to amyloidosis which is one of the hallmarks of Alzheimer's disease.

[uprightdoc]

Costumenational, Regarding C3-C7, you have deformation of your cervial spinal canal in general but you have to triage and pick on majors misalignments first. You have a terrible kink. Working on Atlas is a lot more stable at this point then trying to move something lower down. Your head is way off balance and it is sitting on a stack of books. It is better to bring it back in balance by working on the top book then trying to pull out books from lower down. You have compression of the thecal sac and vertebral veins around C5/6 as I recall. That's permanent but the VVP should be able to handle it. I strong suspect your are compressiong your anterior and posterior spinal arteries as well but that's another story.

[costumenastional]

Your head is way off balance and it is sitting on a stack of books. It is better to bring it back in balance by working on the top book then trying to pull out books from lower down.

This makes sense indeed.

I strong suspect your are compressiong your anterior and posterior spinal arteries as well but that's another story.

as long as chiropractic adjustments can help with this too, even if it takes moths or years.

[scorpion]

One of you asked for the basic thesis of my book. The thesis is that there is a myriad of inherited and acquired types of disorders and degenerative conditions of the spine, especially the upper cervical spine and base of the skull that can disrupt the venous drainage system resulting in chronic edema, ischemia and normal pressure hydrocephalus. These conditions can in turn initiate a cascade of neurodegenerative processes, such as the glutamate cascade, and subsequent diseases. Upright posture predisposes humans to neurodegenerative diseases. It has to do with the unique design of the skull, spine and circulatory system of the brain due to upright posture.

Actually "venous back pressure" is not a new term. I have been discussing it for over twenty-five years. In fact, one of the chapters in the book is called Acute versus Chronc Back Pressure. Blockage of the dural sinuses as a cause of normal pressure hydrocephalus is not new either. Researchers have considered it for decades but could never find the source of the blockage. But they never looked outside the skull. The role of the vertebral veins in upright posture is not my idea either. It comes from physical anthropology. I have forensic evidence of craniosynostosis that resulted in malformed jugular foramen and vertebral vein outlets that is sitting on my desk in front of me at the moment as I write.

I am very busy at this time woring on a new website to complement and expand the blog. I hope to make available PDF copies of my old papers going back to 1987 availble on the website. The papers will include all my sources and citations.

Hmm never heard of it. Have you completed some clinical trials that shows venuous drainage problems predisposes humans to a myriad of neurodegenerative diseases or is it something that you think to be the case. Certainly if you have been discussing it for 25 years you have gathered a great deal of objective research to back up your hypothesis. I look forward to hearing about it!

[uprightdoc]

Scorpion, I cite Adams and Victor from the book Neurology which was published well over twenty years ago regarding the suspected role of venous drainage problems in causing normal pressure hydrocephalus. If you are interested, you should research NPH. I am not about to cite volumes of papers. NPH has been associated with both AD and PD. It has also been associated with Schizophrenia and manic depression, rheumatoid arthritis and lupus erythematosis. MS has been associated with Chiari malformations. Also as I mentioned glaucoma and blindness. The eye is an outgrowth of the third ventricle of the brain and glaucoma can be caused by stenosis and venous comperession resulting in damage to the optic nerve and subsequent blindness. All of these neurodegenerative conditions have been linked to drainage problems. Dr. Noam Alperin of the University of Florida is doing some terrific studies on cranial hydrodynamics such as NPH if you care to read some of his work. It's great material. He read my book and said I did and outstanding job by the way. More importantly, Dr. Schelling's work is based on venous drainage problems and back jets causing MS and Dr. Zamboni bases his work in part on Schelling's research. Lastly, the whole purpose of the Institute for Neurovascular Diseases (INVD) headed by Zamboni is to look into the role of venous drainage problems in neurodegenerative diseases.

[uprightdoc]

I forgot to mention physical anthropological, pathological and comparative anatomical forensic evidence. I have studied normal, pathological and artificially deformed crania as well as comparative anatomical studies of bats whales and giraffes. Bats whales and giraffes face extreme inversion flow against the brain during head inversion and deep dives. Many researchers, such as Schelling suspect inversion flows as possible cause of MS but they haven't done studies either. I was looking for clues about cranial hydrodynamics associated with upright posture. I literally found tons of evidence. Whales were by far the most interesting. As I point out in my book based on my limited humble research, whales use inversion flows in the vertebral veins as a G suit when they dive to protect the brain against increase incranial pressure which is similar to NPH. Giraffes use the diploic spaces and accessory horns as drips pans for inversion flow and my guess is bats use the facial veins. I discuss it in my book which is not about neurodegenerative diseases. It is about upright posture and the the unique design of the human brain.

[HappyPoet]

Welcome, Dr. Flanagan,

Your arrival is perfect timing! Last week, I offered to create for my PCP and myself a summary of conditions/syndromes after we discussed whether or not MS could be just a collection of these and other conditions/syndromes that are tragically misdiagnosed as MS due to the common denominator of neurological symptoms.

If you could please look over your section (and perhaps other sections if you have the time), I would greatly appreciate corrections/comments. Thank you very much!

SUMMARY OF CONDITIONS/SYNDROMES MISDIAGNOSED AS MS

Multiple Sclerosis
MS = Unknown trigger -> immunological BBB breach -> demyelination/axonal loss -> symptoms/lesions.
Cause: Autoimmunity theory (unproven).
Symptoms: Sensory, motor, optic neuritis (ON), cognitive, psychological.
Testing: McDonald Criteria, MRI, EPs, LP. Clinical diagnosis of exclusion. Differential diagnosis.
Treatment: Steroids, CRABs, chemo.
T-cells crossing BBB <--- Excellent "real time" video.

Neuromyelitis Optica (Devic's disease). Asian optic-spinal MS is a variant.
NMO = Aquaporin 4 (AQP4) antibodies -> immunological/antibody BBB breach -> demyelination/axonal loss -> transverse myelitis (TM) and ON with few brain lesions.
Cause: Autoimmunity to white matter nervous system protein (AQP4).
Symptoms: Sensory, motor, ON, cognitive, psychological.
Testing: IgG antibody to AQP4 (70% specificity).
Treatment: Corticosteroids, plasmapheresis.
Mayo Clinic - NMO

Chronically Delusive Misidentification Syndrome (named by Dr. Schelling).
CDMS = Increases in venous pressure -> violent venous back-jets via valveless vertebral veins -> immunological BBB breach -> demyelination/axonal loss -> symptoms/lesions.
Causes: Congenital venous malformation, trauma, CCSVI jugular valve ablation.
Symptoms: Sensory, motor, ON, cognitive, psychological.
Testing: US, MRI.
Treatment: Jugular vein ligature, jugular valve regeneration/reconstruction.
Dr. Schelling MS manuscript, Ch. 5 - Lesions

"Instead of speaking of clinically definite multiple sclerosis, it would be more adequate to speak of cases of unexplained neurological troubles in which the clinicians’ respectively neurologists’ diagnostic repertoire has been exhausted." (Dr. Schelling MS manuscript, Ch. 3 - CDMS)

Chronic Cerebrospinal Venous Insufficiency (named by Dr. Zamboni).
CCSVI = Jugular/azygos stenosis -> reflux -> slow perfusion -> hypoxia -> immunological and red blood cell BBB breach -> iron deposition -> demyelination/axonal loss -> symptoms/lesions.
Cause: Congenital venous malformation.
Symptoms: Fatigue, headache, heat intolerance, ON, tinnitus, brain fog, swelling, TN.
Testing: Doppler US and TC US (flow), MR-venogram (structure), MRI, CT catheter venogram (gold standard), IVUS.
Treatment: Venoplasty, CRABS if helping, stents.
Dr. Zamboni CCSVI study

Chronic Craniocervical Venous Back Pressure (named by Dr. Flanagan).
CCVBP = C1 "Atlas" vertebral misalignment and/or foramen magnum malformation and/or jugular/vertebral vein outlet malformation -> nerve/vein/artery compression -> venous back pressure and/or reduced arterial flow -> venus congestion (edema) and/or reduced arterial oxygen (ischemia) -> immunological BBB breach -> demyelination/axonal loss -> symptoms/lesions.
Causes: Congenital, aging, trauma, poor posture; associated with PD, Alzheimers.
Symptoms: Venous = sensory, motor, ON, cognitive, psychological. Arterial = fatigue, lethargy.
Testing: X-ray, upright MRI, physical exam.
Treatment: Upper cervical correction by Nucca, Atlas orthogonal, and other chiropractic methods.
Uprightdoctor

Cerebellar Thoracic Outlet Syndrome (TOS named by Dr. Noda, retired).
CTOS = Upper-body compression of nerves/veins/arteries by bone/muscle -> symptoms.
Causes: Congenital, collar bone trauma; associated with PD.
Symptoms: Chest pain, dizziness, poor balance; and numbness, weakness, and swelling of neck, shoulder, arm, hand.
Testing: X-ray, physical exam.
Treatment: Correctable with surgical resection of 1st rib bone and/or scalene muscles.
Dr. Poblete Silva

May-Thurner Syndrome (named after Drs. May and Thurner).
MTS Lower-body compression of left iliac vein onto spine by right iliac artery -> symptoms.
Cause: Congenital.
Symptoms: Pain, numbness, weakness, spasticity, and swelling of L or R leg, ankle, foot; deep vein thrombosis (DVT - blood clot).
Testing: CT catheter venogram (enter through left femoral vein), MRI.
Treatment: Correctable with endovascular venous stenting or bypass surgery.
Dr. Raju MTS article

~~~~~~~~~~~~

Edit #1 - More info given on CCSVI (10/6/10).
Edit #2 - More info, links given on MTS, formatting (10/6/10).
Edit #3 - More info given on CCVBP (10/9/10).
Edit #4 - More info, links given on MS, formatting (10/9/10).
Edit #5 - Formatting (12/4/10)
Edit #6 - Fixed broken link for MTS "lower-body" compression link
.

[uprightdoc]

Great stuff.

[uprightdoc]

You did a superb job assembling the info. Venous drainage issues aren't the only problem though. In some cases it has to do with arterial problems, such as symptoms of as fatigue and lethargy for example.
The neuro I learned MS dx from was Dr.Stephen Brumlik of Loyola University. He was neurologist with a graduate degree in neuroscience and a former professor of neurology. Dr. Brumlik broke MS dx down into definite, probable and possible cases. The only definite cases of MS are those associated with more than one supratentorial lesion in the brain.
According to Dr. Brumlike the only real way to dx ms is to rule out everything else. That's how mysterious MS is because there is so much overlap with these other conditions. Like Dr. Zamboni, Dr. Brumlik's wife had MS. There is also overlap between MS migraines.