Journal of Neurology

, Volume 259, Issue 12, pp 2585–2589 | Cite as

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

  • Claudio Baracchini
  • José M. Valdueza
  • Massimo Del Sette
  • Galina Baltgaile
  • Eva Bartels
  • Natan M. Bornstein
  • Juergen Klingelhoefer
  • Carlos Molina
  • Kurt Niederkorn
  • Mario Siebler
  • Matthias Sturzenegger
  • Bernd E. Ringelstein
  • David Russell
  • Laszlo Csiba
Original Communication


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.


CCSVI Ultrasound Multiple sclerosis 


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Claudio Baracchini
    • 1
  • José M. Valdueza
    • 2
  • Massimo Del Sette
    • 3
  • Galina Baltgaile
    • 4
  • Eva Bartels
    • 5
  • Natan M. Bornstein
    • 6
  • Juergen Klingelhoefer
    • 7
  • Carlos Molina
    • 8
  • Kurt Niederkorn
    • 9
  • Mario Siebler
    • 10
  • Matthias Sturzenegger
    • 11
  • Bernd E. Ringelstein
    • 12
  • David Russell
    • 13
  • Laszlo Csiba
    • 14
  1. 1.Department of NeuroscienceUniversity of PaduaPaduaItaly
  2. 2.Neurological CentreSegeberger KlinikenBad SegebergGermany
  3. 3.Department of Neuroscience, Ophthalmology and GeneticsUniversity of GenoaGenoaItaly
  4. 4.Department of NeurologyLatvian Medical AcademyRigaLatvia
  5. 5.Center for Neurological Vascular DiagnosticsMunichGermany
  6. 6.Department of Neurology, Stroke UnitTel Aviv Sourasky Medical CenterTel AvivIsrael
  7. 7.Department of NeurologyMedical Center ChemnitzChemnitzGermany
  8. 8.Hospital Val d’Hebron 119-129BarcelonaSpain
  9. 9.Department of NeurologyMedical University GrazGrazAustria
  10. 10.Department of NeurologyUniversitat DusseldorfDusseldorfGermany
  11. 11.Department of NeurologyUniversity of BernBernSwitzerland
  12. 12.Department of NeurologyUniversity of MunsterMunsterGermany
  13. 13.Department of NeurologyRikshospitalet, The National HospitalOsloNorway
  14. 14.Department of Neurology, Medical SchoolUniversity of DebrecenDebrecenHungary

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