Chronic Cerebral Spinal Venous Insufficiency

There has been a great deal of advances in the field of multiple sclerosis management over the last decade. Of these, a large amount of research has been conducted in analyzing the cause for multiple sclerosis.

In the recent past, a specific area called chronic cerebral spinal venous insufficiency, sometimes called CCSVI, has been described. In this article, we shall take a brief look at this concept and discuss its applications in the management of multiple sclerosis.

What is CCSVI?

CC SVI forms a part of a group of malformations of the venous system within the brain. Various pathologies can affect these veins, particularly the ones close to the internal cervical veins and the azygos vein.

The relationship between CCSVI and multiple sclerosis

Multiple sclerosis is a neurological condition that is characterised by the loss of the protective myelin tissue around the nerves. In other words, it is a demyelinating condition that affects the nerves resulting in alterations in conduction of nerve impulses along the spinal cord. As a result, patients can experience varying degrees of motor weakness which can eventually be rather debilitating.

With regards to the relationship between CCSVI and multiple sclerosis, a theory called ‘liberation treatment’ was proposed by Prof Paulo Zamboni in 2008. There have been a number of different contradictions and issues raised regarding this treatment. Be that as it may, it has been proposed that in patients with CCSVI, the internal jugular veins and the azygos veins are significantly narrowed. This results in a high deposition of iron in the brain which ultimately triggers a series of reactions that can result in the loss of myelin from the surface of the nerves.

Application of CCSVI in the management of multiple sclerosis

The principle of CCSVI in the pathogenesis of multiple sclerosis is now being utilised in treating this condition. Initially, tests are performed to determine the exact point of narrowing within the veins. This test is called a venogram and involves the injection of contrast into the veins and imaging using a specialised x-ray equipment. In some cases, intravascular ultrasound may be used.

Once the narrowings have been determined, stents can be inserted into these narrowed veins or balloon angioplasty may be performed. It is believed that doing so can slow down the process of demyelination and the ultimate development of multiple sclerosis. The procedure is performed under local anaesthetic and guidance of an x-ray machine. The balloon is guided in with the help of a catheter and once in place a metallic stent is put in place to keep the vein open. The procedure takes a few hours to perform and has very good results. Risks are low especially when this procedure is performed by experts.

Procedural costs

Unfortunately, CSSVI treatment is not being performed in United States. However, it is performed by experts for a very reasonable cost in places such as Costa Rica. It is worthwhile making a visit if you have multiple sclerosis or have just been diagnosed with it to obtain this rather remarkable treatment.

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