Chronic cerebrospinal venous insufficiency (CCSVI)

We assess patients with multiple sclerosis or conditions with similar neurological symptoms, non-invasive ultrasound assessment of their jugular and vertebral veins to diagnose the presence of chronic cerebrospinal venous insufficiency (CCSVI).


CCSVI is a syndrome originally postulated by Dr Paolo Zamboni, a well-known Italian vascular surgeon, where abnormal flow of blood in veins draining the brain and spinal cord is associated with multiple sclerosis (MS). CCSVI refers to cerebrospinal venous blood flow disturbances with venous obstructions in the major extracranial veins of the head and neck.  The veins involved include the intracranial veins, jugular veins, vertebral veins and the azygous vein in the chest.

Internal Jugular Vein with distal reflux

Internal Jugular Vein with Obstruction and Reflux  

The venous obstructions include circumferential stenosis of the whole vessel wall, congenital webs, valve abnormalities, vessel hypoplasia, vessel twisting, vessel agenesis and external vessel compression.  Dr Paul Thibault  believes that these venous obstructions are caused by a chronic persistent venulitis caused by the obligate, intracellular parasite called chlamydophila pneumoniae. 


If a patient is diagnosed as having CCSVI on ultrasound examination, they will usually be advised to commence on a prolonged combined antibiotic protocol (CAP) devised by researchers at the Vandebilt University in Nashville, USA.  This appears to benefit both the venous blood flow in the affected veins and helps control many of the neurological symptoms.  

 

 

Dr Paul Thibault's published articles on CCSVI are available for download- CCSVIDuplex Ultrasound Examination

Dr Paul Thibault appearing on Catalyst - transcript

Catalyst

Catalyst Video WMV