6533b829fe1ef96bd128b05b

RESEARCH PRODUCT

Chronic cerebrospinal venous insufficiency: state of the art and research challenges

subject

description

This review discusses a potential vascular basis for multiple sclerosis (MS). The idea that MS could be related to vascular disease is not new, with the first reports describing connections between veins and MS plaques dating from the 19th century. The venous abnormalities found in MS patients, the socalled chronic cerebrospinal venous insufficiency, are currently interpreted as congenital venous malformations. Catheter venography is regarded as the gold standard to assess these lesions, while other tests, such as Doppler sonography and magnetic resonance venography, are much less accurate. Importantly, a relationship between venous pathologies and MS has not yet been proven, especially regarding the causative role of compromised venous outflow in the pathogenesis of MS. Although the results of small open-label studies are promising and treatments have been found to be safe, welldesigned clinical trials will be needed to validate the efficacy of endovascular procedures of malformed veins for the treatment of MS.