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CCSVI chronic cerebrospinal venous insufficiency

See also Multiple Sclerosis (MS)

Dr. Paolo Zamboni, a professor of medicine at the University of Ferrara in Italy appears to have found a connection between iron accumulation and multiple sclerosis (MS).  This accumulation of iron in the brain is due to a reduced flow of blood in the vessels that drain blood from the brain.  He hypothesized that iron damages the blood vessels and allows the metal, along with other unwelcome cells, to cross the brain-blood barrier.  Combine this with the "Iron metabolism in Parkinsonian syndromes" article above, and we have the intriguing idea that perhaps Parkinsonian syndromes are also caused by blood circulation problem.

Researcher's labour of love leads to MS breakthrough
André Picard and Avis Favaro

From Saturday's Globe and Mail Published on Friday, Nov. 20, 2009 9:07PM EST Last updated on Tuesday, Dec. 15, 2009 9:20PM EST

Elena Ravalli was a seemingly healthy 37-year-old when she began to experience strange attacks of vertigo, numbness, temporary vision loss and crushing fatigue. They were classic signs of multiple sclerosis, a potentially debilitating neurological disease.

It was 1995 and her husband, Paolo Zamboni, a professor of medicine at the University of Ferrara in Italy, set out to help. He was determined to solve the mystery of MS – an illness that strikes people in the prime of their lives but whose causes are unknown and whose effective treatments are few.

What he learned in his medical detective work, scouring dusty old books and using ultra-modern imaging techniques, could well turn what we know about MS on its head: Dr. Zamboni's research suggests that MS is not, as widely believed, an autoimmune condition, but a vascular disease.

Fighting for his wife's health, Dr. Zamboni looked for answers in the medical literature. He found repeated references, dating back a century, to excess iron as a possible cause of MS. The heavy metal can cause inflammation and cell death, hallmarks of the disease. The vascular surgeon was intrigued – coincidentally, he had been researching how iron buildup damages blood vessels in the legs, and wondered if there could be a similar problem in the blood vessels of the brain.

Using ultrasound to examine the vessels leading in and out of the brain, Dr. Zamboni made a startling find: In more than 90 per cent of people with multiple sclerosis, including his spouse, the veins draining blood from the brain were malformed or blocked. In people without MS, they were not.

He hypothesized that iron was damaging the blood vessels and allowing the heavy metal, along with other unwelcome cells, to cross the crucial brain-blood barrier. (The barrier keeps blood and cerebrospinal fluid separate. In MS, immune cells cross the blood-brain barrier, where they destroy myelin, a crucial sheathing on nerves.)

More striking still was that, when Dr. Zamboni performed a simple operation to unclog veins and get blood flowing normally again, many of the symptoms of MS disappeared. The procedure is similar to angioplasty, in which a catheter is threaded into the groin and up into the arteries, where a balloon is inflated to clear the blockages. His wife, who had the surgery three years ago, has not had an attack since.

The researcher's theory is simple: that the underlying cause of MS is a condition he has dubbed “chronic cerebrospinal venous insufficiency.” If you tackle CCSVI by repairing the drainage problems from the brain, you can successfully treat, or better still prevent, the disease...


First Blinded Study of Venous Insufficiency Prevalence in Multiple Sclerosis Shows Promising Results

ScienceDaily (Feb. 14, 2010) — More than 55 percent of multiple sclerosis patients participating in the initial phase of the first randomized clinical study to determine if persons with MS exhibit narrowing of the extracranial veins, causing restriction of normal outflow of blood from the brain, were found to have the abnormality... These preliminary results are based on the first 500 participants in the Combined Transcranial and Extracranial Venous Doppler Evaluation (CTEVD) study, which began at UB in April 2009. Investigators are planning to examine 500 additional subjects, who will be assessed in the second phase of the study with more advanced diagnostic tools. Complete data on the first 500 will be presented at the American Academy of Neurology meeting in April. Robert Zivadinov, MD, PhD, UB associate professor of neurology and principal investigator on the study, says he is "cautiously optimistic and excited" about the preliminary data. Zivadinov directs the Buffalo Neuroimaging Analysis Center (BNAC), located in Kaleida Health's Buffalo General Hospital, where the study is being conducted... The investigation is the first step in determining if a condition called chronic cerebrospinal venous insufficiency (CCSVI) is a major risk factor for MS. CCSVI is a complex vascular condition discovered and described by Paolo Zamboni, MD, from Italy's University of Ferrara. Zamboni's original investigation in a group of 65 patients and 235 controls showed CCSVI to be associated strongly with MS, increasing the risk of having MS by 43 fold. Zamboni and Zivadinov hypothesize that this narrowing restricts the normal outflow of blood from the brain, resulting in alterations in the blood flow patterns within the brain that eventually cause injury to brain tissue and degeneration of neurons.

One has to wonder what other diseases CCSVI could cause? (See more at Irony of Iron)

Alzheimer's Disease
...The role venous drainage issues play in the brain in causing neurodegenerative diseases is not new, however. I have been writing about it since 1987. If you do a Google search for "stenosis Alzheimer's" or "NPH Alzheimer's" you will find an article I published in 1990 calling for epidemiological research into the role of venous drainage issues in the brain in Alzheimer's disease.

When I first started looking for a possible cause of normal pressure hydrocephalus I found an old neurology textbook by Adams and Victor. In the section on NPH it stated that, "A matter of considerable interest is the role of blockage of the dural sinuses (the large main veins of the brain) in tension hydrocephalus. The problem is that blockages are rarely found."... http://www.upright-health.com/alzheimers.html

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Updated: July 2, 2012
Inception: July 2, 2012