Chronic cerebrospinal venous insufficiency and cerebrospinal fluid: Another piece of the puzzle?

摘要

Chronic cerebrospinal venous insufficiency (CCSVI) is a theory that has attempted to link venous outflow obstruction from the central nervous system (CNS) with neurologic abnormalities such as multiple sclerosis (MS). In some ways, it has been unfortunate that CCSVI was initially described in the context of a disease such as MS. Enthusiastic and optimistic patients and physicians embraced the early findings of Zamboni et al (1) as an "explanation" and "cure" for this debilitating condition. Venous disease was identified on venography and treated with angioplasty, leading to patient-reported symptomatic improvement. Understandably, this type of fundamental paradigm shift regarding an important disease such as MS was unsettling to many, and some neurologists countered these claims with a very reasonable demand for evidence.