cerebrospinal fluid dynamics (news from Zamboni)

[orion]

see this:


The aim of this study was to investigate the relationship between a Doppler cerebral venous hemodynamic insufficiency severity score (VHISS) and cerebrospinal fluid (CSF) flow dynamics in 16 patients presenting with CCSVI and relapsing-remitting MS (CCSVI-MS) and in eight healthy controls (HCs).

The two groups (patients and controls) were evaluated using validated echo-Doppler and advanced 3T-MRI CSF flow measures. Compared with the HCs, the CCSVI-MS patients showed a significantly lower net CSF flow (p=0.027) which was highly associated with the VHISS (r=0.8280, r2=0.6855; p=0.0001).

This study demonstrates that venous outflow disturbances in the form of CCSVI significantly impact on CSF pathophysiology in patients with MS.

Zamboni P, Menegatti E, Weinstock-Guttman B, Schirda C, Cox JL, Malagoni AM, Hojanacki D, Kennedy C, Carl E, Dwyer MG, Bergsland N, Galeotti R, Hussein S, Bartolomei I, Salvi F, Zivadinov R.

Source: Pubmed PMID: 20018140 (28/02/10)


It is very interesting. Seems like Zamboni goes further.

[thisisalex]

wow
the story continues...

here is a nice introduction to CSF flow....
http://www.youtube.com/watch?v=PUb8iLgpY8E

[cheerleader]

Here is the complete paper:
http://www.fondazionehilarescere.org/pdf/VHISS-CSF.pdf

Normal CSF circulation, in which there is a correct balance between ultrafiltration of CSF (from the veins of the lateral ventricles) and its clearance from the CSF space into the venous system at the level of the dural sinuses, depends on efficient venous drainage (16,24-26). Impaired CSF dynamics may be a factor contributing to the increases in 3rd ventricle and lateral ventricle volumes that we measured (Table II), and that are observed very frequently in MS patients.

Our findings, demonstrating that CCSVI has a significant impact on brain pathophysiology, and particularly on the balance of intracranial fluids, could provide stimulation for the development, in the future, of mathematical models currently lacking (probably because the de-
scription of CCSVI is so recent). A model is needed in which increased resistance of venous outflow is partially corrected by the development of collateral circulations (2,19). Speculatively, the imbalance in CSF filtration-reabsorption processes might be related to increased transmural pressure in the condition of CCSVI (1,5,23, 24). CSF flow assessment is a novel MRI tool, and it would probably be a useful parameter to measure dur-
ing the follow up of patients submitted to endovascular procedures to correct extracranial venous stenoses in CCSVI (5). It can be hypothesized that improved VHISS would correspond to coherent changes in CSF flow dynamics.

I had discussed this with Dr. Dake in relation to the severe headaches Jeff had after his stent procedure. He postulated that the CSF levels had been dramatically altered after correcting venous flow, as in the change created in a lumbar puncture headache (x10).

In Bologna, Dr. Eliot Frohman also discussed how CCSVI could be related to normal pressure hydrocephalus, where the changes in CSF fluid dynamics alters gate, impairs cognition, balance and wakefulness. The third ventricle is also altered in NPH, as it is in MS.

http://www.cerebrospinalfluidresearch.com/content/5/1/9

CSF dynamics is most certainly part of the puzzle-
cheer

[magoo]

Yes, for me it was the LP headache times 10. Such a dynamic change in flow is sure to cause some disturbances for a time. I guess since not all of us have such a bad headache, the pressures must be varied case by case. I can't wait to look back when we have collected enough data to explain all of the idiosyncrasies of CCSVI.