Related Experiment Video
Updated: May 28, 2026
09:41
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Association between chronic cerebrospinal venous insufficiency and multiple sclerosis: a meta-analysis
Andreas Laupacis1, Erin Lillie, Andrew Dueck
1Keenan Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ont. laupacisa@smh.ca
Summary
This meta-analysis found chronic cerebrospinal venous insufficiency (CCVI) is more common in multiple sclerosis (MS) patients. However, study heterogeneity limits definitive conclusions on CCVI as a cause of MS.
Area of Science:
- Neurology
- Vascular Medicine
- Medical Imaging
Background:
- Multiple sclerosis (MS) has been hypothesized to be caused by chronic cerebrospinal venous insufficiency (CCVI).
- CCVI describes ultrasound-detectable venous abnormalities in the brain.
- This study evaluates the association between CCVI and MS.
Purpose of the Study:
- To conduct a meta-analysis of studies investigating the frequency of CCVI in MS patients versus controls.
- To assess the diagnostic utility of ultrasound in identifying CCVI in the context of MS.
Main Methods:
- Systematic literature search of MEDLINE and EMBASE databases.
- Inclusion of studies using ultrasound to diagnose CCVI and compare frequencies between MS patients and controls.
- Meta-analysis and sensitivity analyses were performed to evaluate the association.
Main Results:
- Eight studies were included, with healthy and other neurological disease controls.
- CCVI was significantly more frequent in MS patients compared to healthy controls (OR 13.5).
- While more frequent in MS than other neurological disease controls (OR 32.5), this association lacked statistical significance and showed wide confidence intervals.
Conclusions:
- A positive association exists between CCVI and MS.
- Significant heterogeneity and poor reporting in included studies prevent definitive conclusions.
- Further high-quality research is needed to clarify the role of CCVI in MS pathogenesis.
Related Concept Videos
01:19Multiple Sclerosis l: Introduction
Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
01:29Increased Intracranial Pressure ll: Pathophysiology
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
01:14Increased Intracranial Pressure l: Introduction
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...