Chronic Cerebrospinal Venous Insufficiency (CCSVI)

CCSVI stands for “Chronic Cerebrospinal Venous Insufficiency,” a condition where people have obstructed blood flow in the veins that drain the central nervous system (the brain and spinal cord). Research indicates that CCSVI is significantly correlated with multiple sclerosis. CCSVI may profoundly change the way we think about Multiple Sclerosis. While we are just beginning to understand the link between CCSVI and MS, compelling new research supports further investigation.

The venous abnormalities described above may result in the blood flow rate through the central nervous system back toward the heart becoming slowed, and blood may reflux back toward the brain and spine.

CCSVI is defined by narrowing or in some cases complete obstruction of the Jugular Veins (veins in the neck that carry blood from the head back toward the heart), Azygous vein (vein in the chest that helps carry blood back from the spine), and Pelvic veins (also help drain the spine).

There are several types of blockages that can affect the venous drainage of the head and spine. The most common is a narrowing caused by an abnormal or damaged valve. Other causes include compression of the vein by surrounding structures, congenital narrowing or underdevelopment of the vein, or narrowing away from a valve caused by a number of factors. These have been described as "webs, twists or septums" which refers to the appearance when the veins are studied by Ultrasound or Venograms.

CCSVI has been associated with neurologic symptoms, including headache, fatigue, and generalized weakness, in patients for whom no other cause has been identified. Case experience and preliminary data suggest that improving brain venous drainage can improve symptoms. Drs. Ponec, Saxon, and Gooding use judicious but aggressive angioplasty, reserving the use of stents for only those cases when stents are essential.

Diagnosis

Currently, a variety of technologies are used for diagnosing CCSVI. The most successful are duplex ultrasonography, catheter venography, and Magnetic Resonance Venogram (MRV). Each has unique advantages and disadvantages, and in most cases the combined results of multiple approaches provide the best diagnosis.

Source: CCSVI Alliance, www.ccsvi.org