Chronic Cerebrospinal Venous Insufficiency
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Chronic Cerebrospinal Venous Insufficiency
Chronic cerebrospinal venous insufficiency (CCSVI or CCVI) is a term invented by Italian researcher Paolo Zamboni in 2008 to describe compromised flow of blood in the veins draining the central nervous system. Zamboni hypothesized that it might play a role in the cause or development of multiple sclerosis (MS). Zamboni also devised a surgical procedure which the media nicknamed a liberation procedure or liberation therapy, involving venoplasty or stenting of certain veins. Zamboni's ideas about CCSVI are very controversial, with significantly more detractors than supporters, and any treatments based on his ideas are considered experimental. There is no scientific evidence that CCSVI is related to MS, and there is no good evidence that the surgery helps MS patients. Zamboni's first published research was neither blinded nor did it have a comparison group. Zamboni also did not disclose his financial ties to Esaote, the manufacturer of the ultrasound specifically used in CCSVI ...
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Paolo Zamboni
Paolo Zamboni (born 25 March 1957, Ferrara, Italy) is an Italian doctor and scientist. He is full Professor and Director of the School of Vascular Surgery at the University of Ferrara in Italy. He is known to have discovered, identified and described a vascular disease called chronic cerebrospinal venous insufficiency (CCSVI) strongly related with multiple sclerosis and other neurodegenerative diseases such as Ménière and Parkinson. Biography Graduated with honors in Medicine and Surgery in 1982, Zamboni specialized in General Surgery in 1987 and in Vascular Surgery 1992. In 1992 he obtained the fellowship at the Department of Vascular Surgery of the University of California in San Francisco. From 1993 to 2000 he was visiting professor at the Department of Surgery of the Uniformed Services University of the Health Sciences of Bethesda, Maryland and from 2008 to 2012 at the Jacobs Institute of Neurology in Buffalo, New York, and at the Neuroscience Department of Harvard Unive ...
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Perfusion
Perfusion is the passage of fluid through the circulatory system or lymphatic system to an organ or a tissue, usually referring to the delivery of blood to a capillary bed in tissue. Perfusion is measured as the rate at which blood is delivered to tissue, or volume of blood per unit time (blood flow) per unit tissue mass. The SI unit is m3/(s·kg), although for human organs perfusion is typically reported in ml/min/g. The word is derived from the French verb "perfuser" meaning to "pour over or through". All animal tissues require an adequate blood supply for health and life. Poor perfusion (malperfusion), that is, ischemia, causes health problems, as seen in cardiovascular disease, including coronary artery disease, cerebrovascular disease, peripheral artery disease, and many other conditions. Tests verifying that adequate perfusion exists are a part of a patient's assessment process that are performed by medical or emergency personnel. The most common methods include evalua ...
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Venous
Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenated blood to the heart. In contrast to veins, arteries carry blood away from the heart. Veins are less muscular than arteries and are often closer to the skin. There are valves (called ''pocket valves'') in most veins to prevent backflow. Structure Veins are present throughout the body as tubes that carry blood back to the heart. Veins are classified in a number of ways, including superficial vs. deep, pulmonary vs. systemic, and large vs. small. *Superficial veins are those closer to the surface of the body, and have no corresponding arteries. *Deep veins are deeper in the body and have corresponding arteries. *Perforator veins drain from the superficial to the deep veins. These are usually referred to in the lower limbs and feet. *Communica ...
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Epidemiological
Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population. It is a cornerstone of public health, and shapes policy decisions and evidence-based practice by identifying risk factors for disease and targets for preventive healthcare. Epidemiologists help with study design, collection, and statistical analysis of data, amend interpretation and dissemination of results (including peer review and occasional systematic review). Epidemiology has helped develop methodology used in clinical research, public health studies, and, to a lesser extent, basic research in the biological sciences. Major areas of epidemiological study include disease causation, transmission, outbreak investigation, disease surveillance, environmental epidemiology, forensic epidemiology, occupational epidemiology, screening, biomonitoring, and comparisons of treatment effects such as in clinical trials. E ...
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Spectrum Bias
In biostatistics, spectrum bias refers to the phenomenon that the performance of a diagnostic test may vary in different clinical settings because each setting has a different mix of patients. Because the performance may be dependent on the mix of patients, performance at one clinic may not be predictive of performance at another clinic. These differences are interpreted as a kind of ''bias''. Mathematically, the spectrum bias is a sampling bias and not a traditional statistical bias; this has led some authors to refer to the phenomenon as ''spectrum effects'', whilst others maintain it is a bias if the true performance of the test differs from that which is 'expected'. Usually the performance of a diagnostic test is measured in terms of its sensitivity and specificity and it is changes in these that are considered when referring to spectrum bias. However, other performance measures such as the likelihood ratios may also be affected by spectrum bias. Generally spectrum bias is co ...
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Myelin
Myelin is a lipid-rich material that surrounds nerve cell axons (the nervous system's "wires") to insulate them and increase the rate at which electrical impulses (called action potentials) are passed along the axon. The myelinated axon can be likened to an electrical wire (the axon) with insulating material (myelin) around it. However, unlike the plastic covering on an electrical wire, myelin does not form a single long sheath over the entire length of the axon. Rather, myelin sheaths the nerve in segments: in general, each axon is encased with multiple long myelinated sections with short gaps in between called nodes of Ranvier. Myelin is formed in the central nervous system (CNS; brain, spinal cord and optic nerve) by glial cells called oligodendrocytes and in the peripheral nervous system (PNS) by glial cells called Schwann cells. In the CNS, axons carry electrical signals from one nerve cell body to another. In the PNS, axons carry signals to muscles and glands or from senso ...
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Autoimmunity
In immunology, autoimmunity is the system of immune responses of an organism against its own healthy cells, tissues and other normal body constituents. Any disease resulting from this type of immune response is termed an "autoimmune disease". Prominent examples include celiac disease, post-infectious IBS, diabetes mellitus type 1, Henoch–Schönlein purpura (HSP) sarcoidosis, systemic lupus erythematosus (SLE), Sjögren syndrome, eosinophilic granulomatosis with polyangiitis, Hashimoto's thyroiditis, Graves' disease, idiopathic thrombocytopenic purpura, Addison's disease, rheumatoid arthritis (RA), ankylosing spondylitis, polymyositis (PM), dermatomyositis (DM), Alopecia Areata and multiple sclerosis (MS). Autoimmune diseases are very often treated with steroids. Autoimmunity means presence of antibodies or T cells that react with self-protein and is present in all individuals, even in normal health state. It causes autoimmune diseases if self-reactivity can lead to tiss ...
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Stenotic
A stenosis (from Ancient Greek στενός, "narrow") is an abnormal narrowing in a blood vessel or other tubular organ or structure such as foramina and canals. It is also sometimes called a stricture (as in urethral stricture). ''Stricture'' as a term is usually used when narrowing is caused by contraction of smooth muscle (e.g. achalasia, prinzmetal angina); ''stenosis'' is usually used when narrowing is caused by lesion that reduces the space of lumen (e.g. atherosclerosis). The term coarctation is another synonym, but is commonly used only in the context of aortic coarctation. Restenosis is the recurrence of stenosis after a procedure. Types The resulting syndrome depends on the structure affected. Examples of vascular stenotic lesions include: * Intermittent claudication (peripheral artery stenosis) * Angina ( coronary artery stenosis) * Carotid artery stenosis which predispose to (strokes and transient ischaemic episodes) * Renal artery stenosis The types of stenos ...
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Internal Jugular Vein
The internal jugular vein is a paired jugular vein that collects blood from the brain and the superficial parts of the face and neck. This vein runs in the carotid sheath with the common carotid artery and vagus nerve. It begins in the posterior compartment of the jugular foramen, at the base of the skull. It is somewhat dilated at its origin, which is called the ''superior bulb''. This vein also has a common trunk into which drains the anterior branch of the retromandibular vein, the facial vein, and the lingual vein. It runs down the side of the neck in a vertical direction, being at one end lateral to the internal carotid artery, and then lateral to the common carotid artery, and at the root of the neck, it unites with the subclavian vein to form the brachiocephalic vein (innominate vein); a little above its termination is a second dilation, the ''inferior bulb''. Above, it lies upon the rectus capitis lateralis, behind the internal carotid artery and the nerves passing ...
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Azygos Vein
The azygos vein is a vein running up the right side of the thoracic vertebral column draining itself towards the superior vena cava. It connects the systems of superior vena cava and inferior vena cava and can provide an alternative path for blood to the right atrium when either of the venae cavae is blocked. Structure The azygos vein transports deoxygenated blood from the posterior walls of the thorax and abdomen into the superior vena cava. It is formed by the union of the ascending lumbar veins with the right subcostal veins at the level of the 12th thoracic vertebra, ascending to the right of the descending aorta and thoracic duct, passing behind the right crus of diaphragm, anterior to the vertebral bodies of T12 to T5 and right posterior intercostal arteries. At the level of T4 vertebrae, it arches over the root of the right lung from behind to the front to join the superior vena cava. The trachea and oesophagus is located medially to the arch of the azygous vein. The ...
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Multiple Sclerosis
Multiple (cerebral) sclerosis (MS), also known as encephalomyelitis disseminata or disseminated sclerosis, is the most common demyelinating disease, in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This damage disrupts the ability of parts of the nervous system to transmit signals, resulting in a range of signs and symptoms, including physical, mental, and sometimes psychiatric problems. Specific symptoms can include double vision, blindness in one eye, muscle weakness, and trouble with sensation or coordination. MS takes several forms, with new symptoms either occurring in isolated attacks (relapsing forms) or building up over time (progressive forms). In the relapsing forms of MS, between attacks, symptoms may disappear completely, although some permanent neurological problems often remain, especially as the disease advances. While the cause is unclear, the underlying mechanism is thought to be either destruction by the immune system ...
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Cerebral Veins
In human anatomy, the cerebral veins are blood vessels which drain blood from the cerebrum of the human brain. They are divisible into ''external'' (superficial cerebral veins) and ''internal'' (internal cerebral veins) groups according to the outer or inner parts of the hemispheres they drain into. External veins The external cerebral veins known as the superficial cerebral veins are the superior cerebral veins, inferior cerebral veins, and middle cerebral veins. The superior cerebral veins on the upper side surfaces of the hemispheres drain into the superior sagittal sinus. The superior cerebral veins include the superior anastomotic vein. Internal veins The internal cerebral veins The internal cerebral veins (deep cerebral veins) drain the deep parts of the hemisphere and are two in number; each internal cerebral vein is formed near the interventricular foramina by the union of the superior thalamostriate vein and the ... are also known as the ''deep cerebral veins'' ...
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