Chronic cerebro spinal venous insufficiency (CCSVI): a new hypothesis for Multiple Sclerosis

A controversial nosologic vascular pattern recently identified by Prof. Paolo Zamboni of Ferrara and called Chronic Cerebro Spinal Venous Insufficiency (CCSVI) was associated with multiple sclerosis, bringing a new diagnostics vision and treatment of a disease which currently affects 70,000 Italians.CCSVI is an hemodynamic condition, identified for the first time in 2009 by Prof Zamboni, in which there is an abnormal venous drainage of cerebro-spinal fluid. The venous system obstacle through the internal jugular vein, vertebral veins and the azygos system determines cerebro-spinal fluid stasis, venous reflux and flow reverse through a vicarious cerebro-spinal circuit, resulting in a prolongation of the cerebral circulation, verified with diffusion magnetic resonance studies. There are several clinical conditions such as abnormal coagulation, inflammation, neoplastic compression, which can lead an acute obstruction of the cerebrospinal venous system resulting in severe clinical manifestations, such as dizziness, stiff neck, headache, lethargy; in these conditions percutaneous angioplasty and loco-regional thrombolysis treatments causes regression of symptoms. Zamboni has treated individuals suffering from Multiple Sclerosis’s CCSVI with jugular and azygos angioplasty having positive results.