Sandra Morović

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64 Acta Clin Croat. Vol. 51, (Suppl) No. 2, 2012 CCSVI is a syndrome characterized by stenoses or obstruc-tions of the internal jugular and/or azygosveins with dis-turbed flow and formation of collateral venous channels.Venous anomalies are a field in which experts still have toagree upon many things. We analyzed the data on CCSVIasan entity and its association with MS, and revised the find-ings suggesting a possible connection between these two en-tities.The methodology and results of all published studies onprevalence of CCSVI in MS patients was considered, as wellas other work dealing with possible causes and explanationsof venous, and vascular dysfunctions linked with MS.CCSVI prevalence studies show a great variability in MS pa-tients. However, a recent meta-analysis assessed an over 13times increased prevalence in MS. Global hypo-perfusion ofthe brain, and reduced cerebral spinal fluid dynamics in MSwas shown to be related to CCSVI. Postmortem studiesshow a higher prevalence of intraluminal defects in the mainextracranial vein in MS patients in respect to controls.Careful data analysis may help us conclude that great vari-ability in prevalence of CCSVI in MS patients can be a re-sult of different methodologies used in vein assessment,training, applying of unapproved diagnostic criteria, or dif-ferent approach to the problem itself.CCSVI can be addedto the list of multiple factors involved in MS pathogenesis.It has been proven that smoking is the most important riskfactor for endothelial cell damage, that vitamin D has a pro-tective role and Epstein-Barr virus passes the blood-brainbarrier by invading the endothelial cells, therefore, epi-demiologically, linking the imbalance of these three factorsto MS through autoimmunity.52nd International Neuropsychiatric Pula CongressTHE CONCEPT OF CHRONIC CEREBROSPINAL VENOUS INSUFFICIENCY (CCSVI) IN MULTIPLE SCLEROSIS (MS): A CRITICAL REVIEWSandra Morovic Department of neurology, UHC Sestre milosrdnice, Zagreb, Croatia

The Concept of Chronic Cerebrospinal Venous Insufficiency (CCSVI) In Multiple Sclerosis (MS): A Critical Review

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