Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
BMC Med. 2013 Dec 17;11:260. doi: 10.1186/1741-7015-11-260.
The role of the extracranial venous system in the pathology of central nervous system (CNS) disorders and aging is largely unknown. It is acknowledged that the development of the venous system is subject to many variations and that these variations do not necessarily represent pathological findings. The idea has been changing with regards to the extracranial venous system.
A range of extracranial venous abnormalities have recently been reported, which could be classified as structural/morphological, hemodynamic/functional and those determined only by the composite criteria and use of multimodal imaging. The presence of these abnormalities usually disrupts normal blood flow and is associated with the development of prominent collateral circulation. The etiology of these abnormalities may be related to embryologic developmental arrest, aging or other comorbidities. Several CNS disorders have been linked to the presence and severity of jugular venous reflux. Another composite criteria-based vascular condition named chronic cerebrospinal venous insufficiency (CCSVI) was recently introduced. CCSVI is characterized by abnormalities of the main extracranial cerebrospinal venous outflow routes that may interfere with normal venous outflow.
Additional research is needed to better define the role of the extracranial venous system in relation to CNS disorders and aging. The use of endovascular treatment for the correction of these extracranial venous abnormalities should be discouraged, until potential benefit is demonstrated in properly-designed, blinded, randomized and controlled clinical trials.
颅外静脉系统在中枢神经系统（CNS）疾病和衰老中的作用在很大程度上尚未可知。人们承认，静脉系统的发育受到许多变化的影响，而这些变化不一定代表病理性发现。关于颅外静脉系统的观念一直在发生变化。
最近报道了一系列颅外静脉异常，这些异常可分为结构/形态异常、血流动力学/功能异常以及仅通过综合标准和多模态成像确定的异常。这些异常的存在通常会扰乱正常的血流，并且与突出的侧支循环的发展有关。这些异常的病因可能与胚胎发育停滞、衰老或其他合并症有关。一些 CNS 疾病与颈静脉反流的存在和严重程度有关。最近引入了另一种基于综合标准的血管疾病，即慢性脑脊髓静脉功能不全（CCSVI）。CCSVI 的特征是主要颅外脑脊髓静脉流出道的异常，这可能会干扰正常的静脉流出。
需要进一步研究以更好地定义颅外静脉系统与 CNS 疾病和衰老的关系。在经过精心设计、盲法、随机对照临床试验证明潜在益处之前，应劝阻使用血管内治疗来纠正这些颅外静脉异常。
