6533b834fe1ef96bd129d75f

RESEARCH PRODUCT

Possible Pathomechanisms Responsible for Injury to the Central Nervous System in the Settings of Chronic Cerebrospinal Venous Insufficiency

Marian Simka

subject

Central Nervous SystemPathologymedicine.medical_specialtyCentral nervous systemExcitotoxicityglutamatemultiple sclerosismedicine.disease_causeAxonal injuryCentral Nervous System Diseasescaspase 1venous insufficiencymedicineHumansBrachiocephalic Veinsjugular veinsPharmacologybusiness.industryMultiple sclerosisazygous veinNeurodegenerationPyroptosisGlutamate receptorGeneral Medicineblood-brain barriermedicine.diseaseSpinal cordChronic cerebrospinal venous insufficiencymedicine.anatomical_structureSpinal Cordbusiness

description

The discovery of stenoses in the azygous and internal jugular veins, the so-called chronic cerebrospinal venous insufficiency that accompanies multiple sclerosis, has enabled the reinterpretation of knowledge about this neurologic dis- ease. Pathologic venous outflow from the central nervous system appears to lead to two main problems. Firstly, it disas- sembles the blood-brain barrier and may allow the penetration of nervous parenchyma by glutamate and leukocytes. Sec- ondly, it may result in significant hypoperfusion of the brain and spinal cord. These two overlapping pathologies are likely to trigger plaques through caspase-1-driven pyroptosis of oligodendrocytes and to evoke neurodegeneration via glutamate excitotoxicity. Moreover, brain hypoperfusion may lead to chronic fatigue and other global neurologic symptoms. It is hoped that this review will help to elucidate new strategies and treatments for multiple sclerosis and will show new ave- nues for the research on this debilitating disease.

yearjournalcountryeditionlanguage
2012-03-01Reviews on Recent Clinical Trials
https://doi.org/10.2174/157488712800100198