The role of color Duplex in diagnosing chronic cerebrospinal venous insufficiency in patients with multiple sclerosis

Abstract

IntroductionCCSVI, has been recently hypothesized to play a role in the etiology of MS. It can be reliably assessed using Doppler sonography by evaluating the extra cerebral venous hemodynamics with changes in posture. Aim of studyTo evaluate the prevalence of CCSVI in patients with MS. Patients and methodsA total of 60 patients were studied; (52) with relapsing–remitting MS, (4) with primary progressive MS and (4) with secondary progressive MS. Sixty healthy age and gender-matched controls were enrolled in this study.Patients were subjected to full clinical history, neurological examination and Doppler ultrasound assessment. ResultsCCSVI defined as the presence of at least two positive venous hemodynamic criteria and was present in 8 of the 60 MS patients (13%) and was not found at any of the 60 controls (0%). Four patients showed the full 4 criteria for diagnosis while the other 4 patients only showed 2 criteria. CCSVI was noticed more to be frequent among SP and PP patients (25% and 25% respectively) in respect of RR MS (50%) and showing high significant value. ConclusionWe conclude that CCSVI is an unlikely cause of MS and it is likely to be a late secondary phenomenon.