Chronic Cerebrospinal Venous Insufficiency (CCSVI)
What is CCSVI?
Chronic Cerebrospinal Venous Insufficiency (CCSVI) is an abnormality of blood drainage from the brain and the spinal cord. It is thought to contribute to damage of the nervous system and has therefore been linked to Multiple Sclerosis (MS). Despite the correlation, the medical community is skeptical of possible treatment methods.
MS is a progressive neurological disease. People develop MS which is the deterioration of the linings around nerve fibers and often the fibers themselves are damaged in the brain and spinal cord. As MS develops those inflicted with it develop debilitating neurological symptoms.
The theory that CCSVI leads to MS is no new. As early as 1868 it was known that inflammatory changes were involved with MS and the veins. The theory was revisited in 2009 by Dr. Paolo Zambini of the University of Ferrara Italy. He coined the term and proposed that CCSVI plays a role in the development of MS. He developed a treatment of CCSVI to lower the risk of patients developing MS. Dubbed by the media as “liberation therapy”, treatment involves venoplasty or stenting certain veins to improve blood flow. Additional research is ongoing but Dr. Zambini’s treatment has been criticized by much of the medical community. The stenting can cause serious complications including death. It is not believed that the procedure is worth risking the life of the patient to possibly eliminate the chances of developing MS. It is believed hat CCSVI leads to the red blood cells entering the white matter of the brain and leaving deposits of iron.
Dr. Zambini actively researched CCSVI for a decade before hypothesizing its relationship to MS. He began his extensive research because his wife was diagnosed with MS in 1999. He hoped to find a cure.
Dr. Zambini has proposed that a duplex ultrasound can be done to determine the blood flow in the veins. In order to have CCSVI, Dr. Zambini developed criteria that he found to be mostly met in his patients. This includes blood flowing the wrong way in the vein, extracranial reflux in the internal jugular veins, proximal stenosis of the internal jugular veins, no blood flow in the vertebral veins when lying down or in an upright position and lack of collapse of the venous jublaris when in the upright position.
The Federal Drug Administration has not recognized CCSVI and does not endorse treatment. The surgery to open up the veins in those believed to have CCSVI is risk. Its benefits have not been proven, more research is necessary and standardized clinical testing needs to be done.
Treatment of CCSVI
The procedure to treat CCSVI has been encouraging, however. Patients who have had the endoplastic procedure have had noticeable improvement of their CCSVI symptoms. If CCSVI is proven to be an actual condition and can be correlated to the development of MS, the treatment would be desirable. The development of affirming CCSVI would be a great advance in MS treatment. Patients with any neurodegenerative disease experience symptoms of headaches, sleep disturbance, chronic fatigue, cognitive impairment and thermal intolerance. Reportedly patients who have the endoplastic procedure done experienced some level of relief of these symptoms.
Whether CCSVI is an actual condition and whether it relates directly to MS is still debatable. Research and testing of patients is not done in standard fashion. Clinical trials and further research is necessary to affirm the correlation between CCSVI and MS. Since Dr. Zambini first coined the term Chronic Cerebrospinal Venous Insufficiency the medical community has been excited about the possible correlation along with the skeptical feelings about CCSVI. Nevertheless, research has sped up. In fact, in Canada the theory is widely popular in the medical community and a research group is actively working to prove the correlation between CCSVI and MS.
Although further research needs to be done and a standard of testing is necessary to prove the existence of CCSVI and its link to MS, there is some level of hope that this will help treat MS. If the condition of CCSVI can be proven and is well as its correlation to MS, it could be one of the most hopeful treatments of MS. Those suffering from the debilitating disease would be offered hope in alleviating the painful symptoms and slowing down the progression of the disease.