Chronic Cerebrospinal Venous Insufficiency and Multiple Sclerosis

Multiple sclerosis (MS) is a chronic inflammatory disease of unknown pathogenesis that causes demyelination of the central nervous system. Its cause currently remains unclear, but the underlying etiology is generally considered to be immunologically based. However, some investigations have reported that extracranial venous obstruction and termed chronic cerebrospinal venous insufficiency may have a role in the pathogenesis of MS or in many of its associated clinical manifestations. According to these hypotheses, investigators suggested a method named "liberation therapy" for treating chronic cerebrospinal venous insufficiency including that in jugular and azygos vein angioplasty. Cerebral venous system disorders may be confirmed by non-invasive radiological methods, such as Doppler ultrasonography and magnetic resonance venography, and direct invasive radiological methods, such as catheter venography and intravascular ultrasound. However, the results of the reports in the literature about the frequency and role of chronic cerebrospinal venous insufficiency in MS patients are very conflicting and contradictory.