MND BRIEF: How Accurate Are The Criteria For The Diagnosis of Chronic Cerebrospinal Venous Insufficiency (CCSVI)?

The European Society of neurosonology and cerebral hemodynamics (ESNCH) came out with a strong criticism of  ultrasonographic criteria proposed by the brain hemodynamics community.[1]

"…It is also unclear how it was decided that two or more of these five ultrasound criteria may be used to diagnose CCSVI, since no validation of these criteria was performed by different and independent observers nor were they blindly compared with a validated gold-standard investigation.."

What exactly are those criteria and who authored them? The  ESNCH abstract does not say, but  they are probably similar to the ones  found in a Dutch article found in Phlebology [2] and even described in the Wikipedia entry [3]

Says Wikipedia,

"…It is still not clear whether magnetic resonance venography, venous angiography, or Doppler sonography should be considered the gold standard for the diagnosis of CCSVI…"

[![][1]][2]

Sketch of the vascular system feeding blood to your brain

Your surgeon would then follow the jugular vein and attempt to improve the vein narrowing (stenosis) situation. This is often done by threading a balloon through the vein, as seen below

[![][3]][4]

A CCSVI balloon dilatation of vein

Naturally , even if MS would indeed by caused by CCSVI, the blood circulation could be multiple:

Following Wikipedia:

"…Most of the venous problems in MS patients have been reported to be truncular venous malformations, including azygous stenosis, defective jugular valves and jugular vein aneurysms. Problems with the innominate vein and superior vena cava have also been reported to contribute to CCSVI…"

I am not sure that all of these problems are amenable to the angioplasty type  of procedure.

So CCSVI hopefuls  beware, besides the inherent risks of  CCSVI, the decision criteria as whether to have it or not is under debate.

Talk to your Doctor

_**Sources:**_

1. [Journal of Neurology][5] ; "CCSVI and MS: a statement from the European Society of neurosonology and cerebral hemodynamics." 2012
2. [Phlebology][6] ; "Extra- and transcranial echo colour Doppler in the diagnosis of chronic cerebrospinal venous insufficiency." ; 2012
3. [Wikipedia][7] ; "Chronic cerebrospinal venous insufficiency/diagnosis

Technorati Tags: [angioplasty][8], [balloon dilatation][9], [CCSVI][10], [CCSVI Criteria][11], [ESNCH][12], [multiple sclerosis][13]

[1]: http://www.medinewsdigest.com/wp-content/uploads/2012/06/CCSVI-Veins.png (CCSVI Veins)
[2]: http://www.medinewsdigest.com/wp-content/uploads/2012/06/CCSVI-Veins.png
[3]: http://www.medinewsdigest.com/wp-content/uploads/2012/06/CCSVI-Balloon-Procedure.png (CCSVI Balloon Procedure)
[4]: http://www.medinewsdigest.com/wp-content/uploads/2012/06/CCSVI-Balloon-Procedure.png
[5]: http://www.ncbi.nlm.nih.gov/pubmed/22648477.1
[6]: http://www.ncbi.nlm.nih.gov/pubmed/22312076
[7]: http://en.wikipedia.org/wiki/Chronic_cerebrospinal_venous_insufficiency#Diagnosis
[8]: http://technorati.com/tag/angioplasty
[9]: http://technorati.com/tag/balloon+dilatation
[10]: http://technorati.com/tag/CCSVI
[11]: http://technorati.com/tag/CCSVI+Criteria
[12]: http://technorati.com/tag/ESNCH
[13]: http://technorati.com/tag/multiple+sclerosis

URL: http://www.medinewsdigest.com/?p=4715