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

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Abstract

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.

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Authors and Affiliations

  1. Department of Neuroscience, University of Padua, Via Giustiniani, 5, 35128, Padua, Italy

    Claudio Baracchini

  2. Neurological Centre, Segeberger Kliniken, Bad Segeberg, Germany

    José M. Valdueza

  3. Department of Neuroscience, Ophthalmology and Genetics, University of Genoa, Via de Toni 5, 16132, Genoa, Italy

    Massimo Del Sette

  4. Department of Neurology, Latvian Medical Academy, Baznicas Str. 41/43-23, 1010, Riga, Latvia

    Galina Baltgaile

  5. Center for Neurological Vascular Diagnostics, Weinstr. 5, 80333, Munich, Germany

    Eva Bartels

  6. Department of Neurology, Stroke Unit, Tel Aviv Sourasky Medical Center, 6, Weizman St., 64239, Tel Aviv, Israel

    Natan M. Bornstein

  7. Department of Neurology, Medical Center Chemnitz, Dresdner Str. 178, 09131, Chemnitz, Germany

    Juergen Klingelhoefer

  8. Hospital Val d’Hebron 119-129, 8035, Barcelona, Spain

    Carlos Molina

  9. Department of Neurology, Medical University Graz, Auenbruggerplatz 22, 8036, Graz, Austria

    Kurt Niederkorn

  10. Department of Neurology, Universitat Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany

    Mario Siebler

  11. Department of Neurology, University of Bern, Inselspital, 3010, Bern, Switzerland

    Matthias Sturzenegger

  12. Department of Neurology, University of Munster, Albert-Schweitzer-Str. 33, 48149, Munster, Germany

    Bernd E. Ringelstein

  13. Department of Neurology, Rikshospitalet, The National Hospital, 0027, Oslo, Norway

    David Russell

  14. Department of Neurology, Medical School, University of Debrecen, Nagyerdei krt. 98, 4012, Debrecen, Hungary

    Laszlo Csiba

Authors
  1. Claudio Baracchini
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  2. José M. Valdueza
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  3. Massimo Del Sette
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  4. Galina Baltgaile
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  5. Eva Bartels
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  6. Natan M. Bornstein
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  7. Juergen Klingelhoefer
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  8. Carlos Molina
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  9. Kurt Niederkorn
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  10. Mario Siebler
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  11. Matthias Sturzenegger
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  12. Bernd E. Ringelstein
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  13. David Russell
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  14. Laszlo Csiba
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Corresponding author

Correspondence to Claudio Baracchini.

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Baracchini, C., Valdueza, J.M., Del Sette, M. et al. CCSVI and MS: a statement from the European Society of neurosonology and cerebral hemodynamics. J Neurol 259, 2585–2589 (2012). https://doi.org/10.1007/s00415-012-6541-3

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  • DOI: https://doi.org/10.1007/s00415-012-6541-3

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