March 2013

Introduction

Chronic Cerebrospinal Venous Insufficiency in Multiple Sclerosis

AJNR Editor-in-Chief Mauricio Castillo

AJNR Editor-in-ChiefMauricio Castillo 

In 20071 and then in 20092 Dr. Paulo Zamboni published his best known articles about the association of chronic brain venous obstruction and MS. Zamboni is not a neuroradiologist, a neurosurgeon, or a neurologist but a vascular surgeon who no longer practices as such, as he is afflicted by multifocal motor neuropathy.

It … more »

Extracranial Vascular

Extracranial Venous Drainage Patterns in Patients with Multiple Sclerosis and Healthy Controls

Ryan McTaggart

Ryan McTaggart

When I began my fellowship training in diagnostic neuroradiology and interventional neuroradiology at Stanford University Medical Center in 2010, both the medical world and the lay press were abuzz with the possibility that both MS and idiopathic intracranial hypertension could be, in part, vascular diseases secondary to insufficient venous drainage of the head and neck. … more »

Head & Neck

Value of MR Venography for Detection of Internal Jugular Vein Anomalies in Multiple Sclerosis: A Pilot Longitudinal Study

Robert Zivadinov

Robert Zivadinov

After it was hypothesized that chronic cerebrospinal venous insufficiency (CCSVI) is unique to patients with MS, interest spiked and treatments were sought by and provided to patients around the world. The patient risks and rewards became palpable, yet they have been supported primarily with media-reported anecdotes about both the science itself as well as patient … more »

Expedited Publication

Intra- and Extraluminal Structural and Functional Venous Anomalies in Multiple Sclerosis, as Evidenced by 2 Noninvasive Imaging Techniques

Kresimir Dolic

Kresimir Dolic

We chose to research this topic because CCSVI, from the first moment it was presented, has caused considerable controversy and debate in the medical literature as well as among the population of patients with MS. One of the main criticisms of CCSVI is the uncritical application of interventional procedures in the treatment of CCSVI-related abnormalities … more »

Brain

Positional Venous MR Angiography: An Operator-Independent Tool to Evaluate Cerebral Venous Outflow Hemodynamics

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Pascal Niggeman

The concept of CCSVI challenged the established theories for the development and progression of MS. The data that support CCSVI are discussed controversially, mainly due to the fact that CCSVI can only be diagnosed using Duplex ultrasound (DUS), which is an operator-dependent modality. DUS is the sole method to evaluate a patient in regard to CCSVI because … more »

Brain

No Association Between Conventional Brain MR Imaging and Chronic Cerebrospinal Venous Insufficiency in Multiple Sclerosis

Robert Zivadinov

Robert Zivadinov

While our research points against CCSVI having a primary causative role in the development of MS, we have established that there is a higher prevalence of CCSVI in patients with progressive MS. This finding suggests that CCSVI may contribute to, or be a consequence of, disease progression, with important implications for treating its symptoms. … more »