Journal of Neurology

, Volume 259, Issue 12, pp 2585–2589

CCSVI and MS: a statement from the European Society of neurosonology and cerebral hemodynamics


    • Department of NeuroscienceUniversity of Padua
  • José M. Valdueza
    • Neurological CentreSegeberger Kliniken
  • Massimo Del Sette
    • Department of Neuroscience, Ophthalmology and GeneticsUniversity of Genoa
  • Galina Baltgaile
    • Department of NeurologyLatvian Medical Academy
  • Eva Bartels
    • Center for Neurological Vascular Diagnostics
  • Natan M. Bornstein
    • Department of Neurology, Stroke UnitTel Aviv Sourasky Medical Center
  • Juergen Klingelhoefer
    • Department of NeurologyMedical Center Chemnitz
  • Carlos Molina
    • Hospital Val d’Hebron 119-129
  • Kurt Niederkorn
    • Department of NeurologyMedical University Graz
  • Mario Siebler
    • Department of NeurologyUniversitat Dusseldorf
  • Matthias Sturzenegger
    • Department of NeurologyUniversity of Bern
  • Bernd E. Ringelstein
    • Department of NeurologyUniversity of Munster
  • David Russell
    • Department of NeurologyRikshospitalet, The National Hospital
  • Laszlo Csiba
    • Department of Neurology, Medical SchoolUniversity of Debrecen
Original Communication

DOI: 10.1007/s00415-012-6541-3

Cite this article as:
Baracchini, C., Valdueza, J.M., Del Sette, M. et al. J Neurol (2012) 259: 2585. doi:10.1007/s00415-012-6541-3


To systematically review the ultrasonographic criteria proposed for the diagnosis of chronic cerebrospinal venous insufficiency (CCSVI). The authors analyzed the five ultrasonographic criteria, four extracranial and one intracranial, suggested for the diagnosis of CCSVI in multiple sclerosis (MS), together with the references from which these criteria were derived and the main studies that explored the physiology of cerebrospinal drainage. The proposed CCSVI criteria are questionable due to both methodological and technical errors: criteria 1 and 3 are based on a scientifically incorrect application of data obtained in a different setting; criteria 2 and 4 have never been validated before; criterion 2 is technically incorrect; criteria 3 and 5 are susceptible to so many external factors that it is difficult to state whether the data collected are pathological or a variation from the normal. It is also unclear how it was decided that two or more of these five ultrasound criteria may be used to diagnose CCSVI, since no validation of these criteria was performed by different and independent observers nor were they blindly compared with a validated gold-standard investigation. The European Society of Neurosonology and Cerebral Hemodynamics (ESNCH) has considerable concerns regarding the accuracy of the proposed criteria for CCSVI in MS. Therefore, any potentially harmful interventional treatment such as transluminal angioplasty and/or stenting should be strongly discouraged.


CCSVIUltrasoundMultiple sclerosis

Copyright information

© Springer-Verlag 2012