Document Detail

No evidence of chronic cerebrospinal venous insufficiency at multiple sclerosis onset.
MedLine Citation:
PMID:  21280079     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: An impaired cerebrospinal venous drainage, defined as chronic cerebrospinal venous insufficiency (CCSVI), has been recently hypothesized to be the possible cause of multiple sclerosis (MS). We investigated this hypothesis by studying the occurrence of CCSVI in clinically isolated syndromes (CISs) suggestive of MS.
METHODS: Fifty consecutive patients presenting with a CIS and evidence of dissemination in space of the inflammatory lesions (ie, possible MS [pMS]) underwent a detailed diagnostic workup, including extracranial and transcranial venous echo-color Doppler sonography (ECDS-TCDS). Those with CCSVI underwent selective venography. Fifty healthy subjects (HCs) age-matched and gender-matched with pMS patients (HC1); 60 patients with transient global amnesia (TGA); and 60 healthy subjects age-matched and gender-matched with TGA patients (HC2) constituted the control groups and underwent ECDS-TCDS.
RESULTS: Mean age of pMS patients was 33.0 ± 8.5 years (range, 14-50); 35 (70%) were female (female:male ratio, 2.3). TCDS was normal in all pMS patients. One or more abnormal ECDS findings were observed in 26 of 50 (52.0%) pMS patients, in 35 of 110 (31·8%) HCs (HC1+HC2), and in 41 of 60 (68.3%) TGA patients. Eight (16%) pMS patients fulfilled the diagnosis of CCSVI. Selective phlebography performed in 7 of these patients (1 denied consent) did not show venous anomalies.
INTERPRETATION: Our findings do not support a cause-effect relationship between CCSVI and pMS. Further studies are warranted to clarify whether CCSVI is associated with later disease stages and characterizes the progressive forms of MS.
Claudio Baracchini; Paola Perini; Massimiliano Calabrese; Francesco Causin; Francesca Rinaldi; Paolo Gallo
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of neurology     Volume:  69     ISSN:  1531-8249     ISO Abbreviation:  Ann. Neurol.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-31     Completed Date:  2011-03-16     Revised Date:  2011-09-07    
Medline Journal Info:
Nlm Unique ID:  7707449     Medline TA:  Ann Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  90-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 American Neurological Association.
First Neurology Clinic, University Hospital, Padova, Italy.
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MeSH Terms
Amnesia / diagnosis,  ultrasonography
Azygos Vein / pathology,  ultrasonography
Cerebral Veins / pathology,  ultrasonography
Cerebrospinal Fluid / physiology
Constriction, Pathologic / pathology,  ultrasonography
Jugular Veins / abnormalities,  pathology,  ultrasonography
Magnetic Resonance Imaging
Middle Aged
Multiple Sclerosis / diagnosis,  etiology*,  ultrasonography
Multiple Sclerosis, Relapsing-Remitting / diagnosis,  pathology
Phlebography / methods,  statistics & numerical data
Regional Blood Flow
Ultrasonography, Doppler, Color
Venous Insufficiency / complications*,  diagnosis,  ultrasonography
Vertebral Artery / pathology,  ultrasonography
Comment In:
Ann Neurol. 2011 Jun;69(6):1062-3; author reply 1063   [PMID:  21681801 ]
Ann Neurol. 2011 Jul;70(1):181; author reply 181-2   [PMID:  21674590 ]

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