UPDATE 2013: Researchers at BNAC discover that venoplasty increases the rate of flow of CSF in the brains of those treated for CCSVI. CSF flow continues to improve a year after treatment.
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CSF and CCSVI will be the focus of an upcoming roundtable discussion, hosted by CCSVI Alliance in New Orleans this coming April.
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Most of us know about cerebral spinal fluid-- as it is currently used in the diagnosis of MS. A lumbar puncture (or spinal tap) removes some of this liquid from the spine. If there are specific markers in the fluid, called oligoclonal banding, it is a sign that myelin is being degraded in the central nervous system.
But CSF is vitally important to brain health. We've know that CSF is part of the equation in blood flow in CCSVI. In fact, Dr. Zamboni noted that the severity of CCSVI was related to altered CSF flow in this study: link
Most of the published CCSVI research is focused on measuring blood flow. But the brain and spine are unique in the body, in that CSF factors into blood volume in the central nervous system.
I first wrote about CSF on the forum This is MS in 2009--because I'd returned from Bologna and heard a neurologist discussing how he believed CCSVI might be related to normal pressure hydrocephalus (NPH), or an increase in pressure in the brain from CSF.
link to forum
I wanted to explain this, because we are going to hear more about the importance of CSF flow in the coming months. There are some very exciting developments happening right now in CCSVI research, and they involve CSF flow. I want to focus on CSF today, so we can all be on the same page.
Cerebral Spinal Fluid has four very important functions for the brain.
1. Supports the brain. The weight of the brain is suspended in cerebral spinal fluid.
2. Protects the brain. By providing a cushioning space around tissue
3. Cleanses the brain. Rinses metabolic waste through the blood brain barrier and out through venous bloodflow.
4. Maintains perfusion level of the brain. CSF is self-regulating, and lessens volume when there is a problem with perfusion. When CSF levels increase, perfusion (cerebral blood flow) of the brain decreases.
There is a wonderful physician many of you already know about. He calls himself the Upright Docotor, and he has a very interesting webpage where he discusses his decades of research into neurodegenerative disease, CSF, bloodflow and what happens to our venous return when we are in the upright position. For those who do not yet know about Dr. Flanigan's work, here is his webpage:
link to the Upright Doctor
Dr. Flanigan writes about the importance of alignment in the cervical and lower spine in relationship to brain and spinal health. One of his areas of interest is in CSF pulsations, or waves-- and the damage these waves can inflict on brain and spinal tissue. This is from his site:
Strong CSF pulsations are a sign of good circulation and health. Weak pulsations are a sign of ill health and old age. On the other hand, when they get out of hand, waves can move boulders in rivers and tear apart the most imposing shorelines and obstacles.
If the pulsations can shape, indent and move the bones of the skull they can easily compress, dent and deform the brain and, in fact, they do. When the heart contracts a considerable amount of blood is driven into the brain, which compresses the brain, veins and CSF pathways. This drives venous blood and CSF out of the cranial vault and brain. When the heart relaxes, the brain, veins and CSF pathways expand which draws blood into the tissues of the brain, and pulls waste out of tissue spaces and into the drainage system ready to be removed on the next cycle.
The heart thus causes the brain to rhythmically expand and contract. Problems occur when waves get out of control. I liken them to rogue waves and describe them in more detail on my prior post. When CSF volume gets out of control it can damage the brain. Likewise, when CSF waves get out of control they can damage the brain as well. The basal cisterns (wells) that surround the brainstem and cerebellum with CSF, are the first place to experience the brunt of rogue waves and the most likely to suffer the consequences. I suspect that chronic pounding from rogue waves can cause damage.
link
There is much more coming, as research continues into how CSF factors into brain health in neurodegenerative disease, and how the architecture of the spine contributes. And this is related to CCSVI severity. The phrase, "tip of the iceberg" comes to mind.
Here is a video of what CSF pulsations look like in the brain on MRI-
link to video
Let's learn more about CSF and the brain--here's to more information in the months ahead!
Joan
