The complete paper is here: link
As many of my readers know, there has been very little study of the outgoing venous system, especially when compared to the ingoing arterial side of blood flow. We have a well-documented understanding of how problems with carotid arteries, the main inflowing blood vessels to the brain, can cause disease. link There are many papers on carotid arterial stenosis and stroke, dementia, Alzheimer's and other diseases of neurodegeneration. And carotid artery scans are quite commonplace. Angioplasty treatment for carotid arterial disease is an accepted and even routine practice today.
But in contrast, the venous system, specifically the internal jugular veins which are the main drainage route for the brain, has been under-researched and is not well understood. A common thought from doctors has been that the brain can utilize collateral veins to drain, and that when the jugular veins are blocked, it's no big deal, since there are other veins to take up the flow. This paper is one of the first which is looking specifically at how blockage of the IJV changes venous flow patterns.
In a study of 153 people with MS, 55% of the MS group exhibited jugular venous stenosis. In the healthy control group of 105 people, 20% had stenotic veins. Both of these groups had collateral venous flow, either through the vertebral or paraspinal veins. The anatomic assessment of these vessels really isn't the complete picture. Remember Dr. Zamboni's quote--"It's not the architecture, it's the flow."
Collateral flow has hemodynamic consequences. This collateral system is like taking a winding country road when the main highway is blocked. It is slower, less direct and has consequences for the brain, including venous hypertension and venous insufficiency. There will be further research on the hemodynamic consequences of collateral venous flow.
One of the leading researchers publishing on this link is ISNVD member Professor Clive Beggs.
But we have also seen new publications like this one from radiologists, and contributions from groups like the Nedergaard Lab, the Kipnis Lab, the Gladstone Lab and the ISNVD. These groups are publishing on the newly discovered lymphatic system, which relies on the venous system of the brain. We are now seeing how absolutely vital the brain's veins are--and how problems in venous flow are linked to all diseases of neurodegeneration. This is real, and the science is coming in. link
For those who are "out of wait" and frustrated by the pace of this research--it is best to consider the vascular connection to MS and live your most endothelially healthy life today. Talk to your own doctor about eating whole, colorful natural foods, exercising or physical therapy, getting UV ray exposure, increasing quality sleep, reducing stress, and finding joy and community. Maybe consider NUCCA or atlas orthogonal treatments, having your venous system scanned for irregularities and getting treatment from a respected IR.
Be hopeful, and be well.
Showing 99% and 70% obstructed IJVs and collateral flow (those curly, small veins) before his venoplasty treatment