Medical Biophysics Laboratory, School of Engineering, Design and Technology, University of Bradford, Bradford, West Yorkshire BD7 1DP, UK.
BMC Med. 2013 May 31;11:142. doi: 10.1186/1741-7015-11-142.
Venous abnormalities contribute to the pathophysiology of several neurological conditions. This paper reviews the literature regarding venous abnormalities in multiple sclerosis (MS), leukoaraiosis, and normal-pressure hydrocephalus (NPH). The review is supplemented with hydrodynamic analysis to assess the effects on cerebrospinal fluid (CSF) dynamics and cerebral blood flow (CBF) of venous hypertension in general, and chronic cerebrospinal venous insufficiency (CCSVI) in particular.CCSVI-like venous anomalies seem unlikely to account for reduced CBF in patients with MS, thus other mechanisms must be at work, which increase the hydraulic resistance of the cerebral vascular bed in MS. Similarly, hydrodynamic changes appear to be responsible for reduced CBF in leukoaraiosis. The hydrodynamic properties of the periventricular veins make these vessels particularly vulnerable to ischemia and plaque formation.Venous hypertension in the dural sinuses can alter intracranial compliance. Consequently, venous hypertension may change the CSF dynamics, affecting the intracranial windkessel mechanism. MS and NPH appear to share some similar characteristics, with both conditions exhibiting increased CSF pulsatility in the aqueduct of Sylvius.CCSVI appears to be a real phenomenon associated with MS, which causes venous hypertension in the dural sinuses. However, the role of CCSVI in the pathophysiology of MS remains unclear.
静脉异常与多种神经状况的病理生理学有关。本文综述了多发性硬化症（MS）、白质疏松症和正常压力脑积水（NPH）中静脉异常的文献。该综述补充了流体动力学分析，以评估静脉高压对脑脊液（CSF）动力学和脑血流（CBF）的一般影响，以及慢性脑静脉功能不全（CCSVI）的影响。CCSVI 样静脉异常似乎不太可能导致 MS 患者的 CBF 降低，因此必须有其他机制在起作用，这些机制增加了 MS 患者脑血管床的水力阻力。同样，血流动力学变化似乎是导致白质疏松症 CBF 降低的原因。室周静脉的流体动力学特性使这些血管特别容易受到缺血和斑块形成的影响。硬脑膜窦中的静脉高压会改变颅内顺应性。因此，静脉高压可能会改变 CSF 动力学，影响颅内风箱机制。MS 和 NPH 似乎具有一些相似的特征，两者在中脑导水管都表现出 CSF 脉动增加。CCSVI 似乎是一种与 MS 相关的真实现象，它会导致硬脑膜窦中的静脉高压。然而，CCSVI 在 MS 病理生理学中的作用仍不清楚。
