Chronic cerebral venous dysfunction: diagnostic and treatment-and-prophylactic aspects

Authors

  • O.Ye. Kovalenko Shupyk National University of Public Health of Ukraine, Kyiv, Ukraine; State Scientific Institution “Scientific and Practical Center of Preventive and Clinical Medicine” of the Agency of State Affairs, Kyiv, Ukraine, Ukraine https://orcid.org/0000-0002-5927-5565
  • N.G. Prityko State Scientific Institution “Scientific and Practical Center of Preventive and Clinical Medicine” of the Agency of State Affairs, Kyiv, Ukraine; Municipal Non-Profit Enterprise “Consulting and Diagnostic Center” of Sviatoshynskyi District, Kyiv, Ukraine, Ukraine

DOI:

https://doi.org/10.22141/2224-0713.17.2.2021.229898

Keywords:

syndrome of chronic cerebral venous dysfunction, venous system of the brain, diagnosis, treatment

Abstract

As a continuation of the topic of the article in the previous issue of the International Neurological Journal, which presents an analytical review of domestic and foreign studies on the syndrome of chronic cerebral venous dysfunction (SСCVD), this section discusses the classification of pathology, key issues of diagnosis and treatment. It is noted that in Ukraine and in most countries of the post-Soviet space, clinical classifications of M.Ya. Berdychevsky and A.V. Shemagonov are still used, where clinical forms, etiological factors, stages and types of the pathology were identified. In the ICD-10, venous cerebral insufficiency may correspond to the following chapters: G46, I87.8, I98, I99. Diagnosis of SCСVD, first of all, is based on a clinical assessment. Having quite characteristic general clinical symptoms, the pathology nevertheless differs in certain features of the course. Most often patients with SCСVD complain of chronic stabbing, monotonous headache, a feeling of heaviness in the head and so on. In addition, most patients have constant or intermittent noise in the head, ears, dizziness and vertigo. Additional verification methods are ultrasound examination of the vessels of the head and neck, plethysmography, magnetic resonance angiography. Since SCСVD is not an independent unit, the treatment of this pathology primarily requires the elimination of the underlying disease that provoked cerebral venous discirculation. As important preventive and curative measures, non-drug methods that reduce congestion in the body should be considered: regular physical activity, dosed exercises for the spine, various types of massage and physiotherapy, reflexology. It is important to adhere to a certain diet and quality of food. Among venotonic drugs, there are those of plant origin (flavonoids and saponins), synthetic agents, combined drugs.

References

Caso V., van der Worp H.B., Fischer U. European Stroke Organizational Report Stroke. 2017 Aug. 48(8). e195-e196. doi: 10.1161/STROKEAHA. 117.016050. Epub 2017 Jul 13.

Beggs C.B. Venous hemodynamics in neurological disorders: an analytical review with hydrodynamic analysis. BMC Med. 2013. 11. 142. doi: 10.1186/1741-7015-11-142.

Коваленко О.Є. Ранні прояви і динаміка розвитку вертебрально-базилярної дисциркуляції, пов’язаної з цервіковертеброгенною дисфункцією, та напрями до її профілактики та лікування. Лікарська справа. 2004. № 3-4. С. 46-54.

Osborn`s Brain: Imaging, Pathology, and Anatomy (second edition), by Anne G. Osborn, Gary L. Hedlund, Karen L. Salzman. Elsevier; 2 edition (November 2, 2017) ISBN-13: 978-0323477765б, ISBN-10: 0323477763. 1300 p.

Клоссовский Б.Н. Циркуляция крови в мозге. М., 1951. 300 с. https://medklassika.ru/klossovski_1951/4/

Wilson M.H. Monro-Kellie 2.0: The dynamic vascular and venous pathophysiological component of intracranial pressure. J. Cereb. Blood Flow Metab. 2016 Aug. 36(8). 1338-50. doi: 10.1177/0271678X16648711. Epub 2016 May 12.

Шемагонов А.В. Синдром хронической церебральной венозной дисциркуляции. Український медичний часопис. 2007. Т. 5(61)-ІХ-Х. С. 33-36.

Чуканова Е.И., Чуканова А.С., Мамаева Х.И. Хроническая церебральная венозная недостаточность, этиология, клиника, лечение. 2015. www.poliklin.ru> article2018_1(1).

Бердичевский М.Я. Венозная дисциркуляторная патология головного мозга. М., 1989. 224.

Zamboni P., Galeotti R. The chronic cerebrospinal venous insufficiency syndrome. Phlebology. 2010. 25. 269-279. doi: 10.1258/phleb.2010.009083.

Recommendations for Multimodal Noninvasive and Invasive Screening for Detection of Extracranial Venous Abnormalities Indicative of Chronic Cerebrospinal Venous Insufficiency: A Position Statement of the International Society for Neurovascular Disease. ISNVD Position Statement: Screening Recommendations for CCSVI Zivadinov et al. JVIR. https://www.isnvd.org/files/JVIR-ISNVD%20position%20statement-Multimodal%20imaging%20for%20CCSVI.pdf

Коваленко О.Є., Притико Н.Г. Хронічна церебральна венозна дисфункція: поширеність та фактори ризику. Здобутки клінічної і експериментальної медицини. № 1. Тернопіль, 2019. С. 74-79.

Dolic K., Weinstock-Guttman B., Marr K., Valnarov V., Carl E., Hagemeier J., Kennedy C., Kilanowski C., Hojnacki D., Ramanathan M., Zivadinov R. Heart disease, overweight, and cigarette smoking are associated with increased prevalence of extra-cranial venous abnormalities. Neurol. Res. 2012. 34. 819-827. doi: 10.1179/1743132812Y.0000000062.

Zivadinov R., Chung C. Potential involvement of extracranial venous system in central nervous system disorders and aging. BMC Med. 2013. 11. 260. 10.1186/1741-7015-11-260.

Lu-Sha Tong, Zhen-Ni Guo, Yi-Bo Ou, Yan-Nan Yu, Xiao-Cheng Zhang, Jiping Tang, John H. Zhang, Min Lou. Cerebral venous collaterals: A new fort for fighting ischemic stroke? https://doi.org/10.1016/j.pneurobio.2017.11.001

Dolic K., Siddiqui A., Karmon Y., Marr K., Zivadinov R. The role of noninvasive and invasive diagnostic imaging techniques for detection of extra-cranial venous system anomalies and their development variants. BMC Med. 2013. 11. 155. doi: 10.1186/1741-7015-11-155.

Zamboni P., Galeotti R., Menegatti E., Malagoni A.M., Tacconi G., Dall'Ara S. et al. Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis. Journal of Neurology, Neurosurgery, and Psychiatry. April 2009. 80(4). 392-9. doi: 10.1136/jnnp.2008.157164. PMC 2647682. PMID 19060024.

Zivadinov R., Marr K., Cutter G. et al. Prevalence, sensitivity, and specificity of chronic cerebrospinal venous insufficiency in MS. Neurology. 2011. 77(2). doi: https://doi.org/10.1212/WNL.0b013e318212a90.

Zivadinov R., Ramanathan M., Dolic K., Marr K., Karmon Y., Siddiqui A.H., Benedict R.H., Weinstock-Guttman B. Chronic cerebrospinal venous insufficiency in multiple sclerosis: diagnostic, pathogenetic, clinical and treatment perspectives. Expert Rev. Neurother. 2011. 11. 1277-1294. doi: 10.1586/ern.11.117.

Zuuren E.J., Fedorowicz Z., Pucci E., Jagannath V.A., Robak E.W. Percutaneous transluminal angioplasty for treatment of chronic cerebrospinal venous insufficiency (CCSVI) in multiple sclerosis patients. Cochrane Database of Systematic Reviews. 2012. 12. Art. No.: CD009903. doi: 10.1002/14651858.CD009903.pub2.

Michael D., Dake M.D. Chronic Cerebrospinal Venous Insufficiency and Multiple Sclerosis: History and Background. Techniques in Vascular and Interventional Radiology. June 2012. 15. 2. 94-100. https://doi.org/10.1053/j.tvir.2012.02.002.

Zivadinov R., Cutter G., Marr K., Ramanathan M., Benedict R.H., Bergsland N., Morgan C., Carl E., Hojnacki D., Yeh E.A., Willis L., Cherneva M., Kennedy C., Dwyer M.G., Weinstock-Guttman B. No association between conventional brain MR imaging and chronic cerebrospinal venous insufficiency in multiple sclerosis. AJNR Am. J. Neuroradiol. 2012. 33. 1913-1917. doi: 10.3174/ajnr.A3112.

Gandhi S., Marr K., Mancini M. et al. No association between variations in extracranial venous anatomy and clinical outcomes in multiple sclerosis patients over 5 years. BMC Neurol. 2019. 19. 121. https://doi.org/10.1186/s12883-019-1350-2.

Tsivgoulis G., Faissner S., Voumvourakis K., Katsanos A.H., Triantafyllou N., Grigoriadis N., Gold R., Krogias C. “Liberation treatment” for chronic cerebrospinal venous insufficiency in multiple sclerosis: the truth will set you free. Brain Behav. 2015 Jan. 5(1). 3-12. doi: 10.1002/brb3.297. Epub 2014 Nov 21.

Julayanont P., Karukote A., Ruthirago D., Panikkath D., Panikkath R. Idiopathic intracranial hypertension: ongoing clinical challenges and future prospects. J. Pain Res. 2016. 9. 87-99.

Petolicchio B., Viganò A., di Biase A. et al. Cerebral venous hemodynamic abnormalities in episodic and chronic migraine. Funct. Neurol. 2016. 31. 81-86.

Toma G., Onorati P., Bellagamba G., Vernetti Prot M., Lupattelli T. The intra and extra cranial veins in relationship with chronic migraine. Veins and Lymphatics. 2019. 8(2). https://doi.org/10.4081/vl.2019.8435.

Bruno A., Napolitano M., Califano L., Attanasio G., Giugliano V. at al. The Prevalence of Chronic Cerebrospinal Venous Insufficiency in Meniere Disease: 24-Month Follow-up after Angioplasty. Journal of Vascular and Interventional Radiology. January 19, 2017. 28. 3. 388-391. doi: http://dx.doi.org/10.1016/j.jvir.2016.10.019.

Верещагин Н.В. Патология вертебрально-базилярной системы и нарушения мозгового кровообращения. М.: Медицина, 1980. 311 с.

Wilson M.H., Imray C.H.E. The Cerebral Venous System and Hypoxia. 25 Articles in Press. J. Appl. Physiol. August 20, 2015.

Wright A., Edsell M., Kitchen N.D., Sharp D.J., Ham T.E., Murray A., Holloway C.J., Clarke K., Grocott M.P.W., Montgo-mery H., Imray C. Birmingham Medical Research Expeditionary Society and Caudwell Xtreme Everest Research Group. Cerebral venous system and anatomical predisposition to high-altitude headache. Ann. Neurol. 2013. 73. 381-389.

Wilson M.H., Edsell M.E.G., Davagnanam I., Hirani S.P., Martin D.S., Levett D.Z.H., Thornton J.S., Golay X., Strycharczuk L., Newman S.P., Montgomery H.E., Grocott M.P.W., Imray C.H.E. Caudwell Xtreme Everest Research Group. Cerebral artery dilatation maintains cerebral oxygenation at extreme altitude and in acute hypoxia — an ultrasound and MRI study. J. Cereb. Blood Flow Metab. 2011. 31. 2019-2029.

Руководство анатомии человека [Текст]: [сочинение] А. Раубера, ординарнаго профессора Императорскаго Юрьевскаго университета/в обработке [и с предисл.] д-ра Ф. Копша, экстраординарнаго профессора Берлинскаго университета. С.-Петербург: издание К.Л. Риккера, 1910–1915. Т. 3: Мышцы и сосуды: с 407 рисунками/пер. с 8-го изд. Под ред. д-ра мед. К.З. Яцуты. 1911. VIII, 518, [1] с.: ил., цв. ил., табл.

Злотников М.Д. Венозная система человека. Краткий атлас в двух томах. М.: Медицина, 1947. 152 с.

Бабский Е.Б., Косицкий Г.И., Ходоров Б.И. Физиология человека. Учебное пособие. М.: Медицина, 1985. 544 с.

Горчаков В.Н. Нейрохирургическая анатомия головного мозга: учеб. пособие. Новосиб. гос. ун-т. Новосибирск: РИЦ НГУ, 2015. 124 с.

Верулашвили И., Кортушвили М., Берая М. Особенности венозной церебральной гемодинамики при хронических нарушениях мозгового кровообращения. Неврология и психиатрия. Спецвыпуск «Вторая столица». Эффективная фармакотерапия. № 24. Тбилиси, 2018. С. 1-5.

Белова Л.А., Машин В.В., Моисеев М.Ю., Белов Д.В. Нарушение мозгового венозного кровотока у больных с гипертонической дисциркуляторной энцефалопатией. Клиническая фармакология и терапия. 2018. 27(4).

International Statistical Classification of Diseases and Related Health Problems 10th Revision Version: 2019 URL: https://icd.who.int/browse10/2019/en

Лелюк В.Г., Лелюк С.Е. Ультразвуковая допплеровская ангиология. Практическое пособие. 2-е изд., допол. и перераб. М.: Реальное время, 2014. 322 с.

Приходько В.Ю., Кашковський Д.О. Синдром хронічної венозної дисциркуляції головного мозку. К.: Семейная медицина, 2013. № 5. С. 65-72.

Кузнецов В.В., Шульженко Д.В. Особенности диагностики и лечения венозной энцефалопатии. The Journal of Neuroscience of B.M. Mankovskyi. 2015. Т. 3. № 1. С. 97-104.

Кононець О.М. Проблема хронічної церебральної венозної конгестії в структурі соматоневрології: діагностичні та лікувальні аспекти. Міжнародний неврологічний журнал. 2019. № 7. С. 31-36. http://nbuv.gov.ua/UJRN/Mnzh_2019_7_7.

Published

2021-05-19

Issue

Section

To practicing Neurologist