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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2012 October;171(5):605-11
Chronic cerebrospinal venous insufficiency in amyotrophic lateral sclerosis
Grozdinski L. 1, Petrov I. 2, Iloska M. 1
1 Angiology and Phlebology Sector, Clinic of Cardiology and Angiology, Tokuda Hospital, Sofia, Bulgaria;
2 Clinic of Cardiology and Angiology, Tokuda Hospital, Sofia, Bulgaria
Aim. CCSVI probably is not only a risk factor for development of MS, but it is the basic ethiopathogenetical factor. The dysfunction of the blood brain barrier (BBB) appeared as a result of CCSVI can also be one of the main reasons for triggering of neurodegenerative or autoimmune processes in MS. Following this hypothesis we can assume that CCSVI is the main ethiopathogenetic factor in other neurodegenerative diseases such as amyotrophic lateral sclerosis (ALS). Up to this moment the literature has no data for Doppler or Venography examination for CCSVI in patients with ASL. The aim of this research is screening of ALS patients for CCSVI using EchoDoppler and venography.
Methods. Seven patients with ALS were examined.
Results. The patients diagnose was confirmed based on clinical symptoms and electromyography. Both jugular vein (draining the blood from the brain) and the azygos vein (draining the blood from the spinal cord) were examined by EchoDoppler and venography. In all of the patients with ALS CCSVI was determined- severe stenosis in jugular veins. In five of the patients was determined severe stenosis in the azygos vein. In all of our patients endovascular therapy was performed- balloon dilatation of jugular and azygos vein with good angiographic result- normal blood flow and diameter of the veins.
Conclusion. The discovery of CCSVI in seven patients with ALS is probably not a coincidence and raises the necessity of conduction of a systematic research for CCSVI in of patients with ALS.