The Possible Role of Cranio-Cervical Trauma and Abnormal CSF Hydrodynamics in the Genesis of Multiple Sclerosis

Physiol. Chem. Phys. & Med. NMR (20 September 2011) 41: 1–17, Raymond V. Damadian and David Chu

Results
CSF Flow Imaging and Quantification in Multiple Sclerosis Patients.
The ?rst, and partially expected result stemming from the MR images of MS patient #1(Figure 1a) and the known periventricular distribution of MS lesions (Figure I, II), was the ?nding of abnormal CSF ?ows in all eight MS patients (Figures 1–8, Table 2A, col.10). The abnormal CSF ?ows corresponded with the cranio-cervical structural abnormal-ities found on the patients’ MR images.
The second ?nding was a history of severe cervical trauma prior to the patient’s MS diagnosis in six of the eight MS patients and a signi?cant possibility of cervical trauma in a seventh patient (Table 1, MS patient #8).
The third ?nding was the discovery that CSF in?ow (cc/sec) and in?owvelocity (cm/sec) in the upright position is about half (53–56%) (Table 3) of what it was in the recumbent position in both the MS patients and normal examinees.
Alperin et al. have shown that the average (oscillatory) CSF volume (cc) in the upright position was less than half the oscillatory volume (cc) in the supine position, but neither a reduction of CSF in?ow velocity (cm/sec) nor of CSF in?ow(cc/sec) in the upright position have been previously reported (3).
The ?rst important observation of this study of eight MS patients was that every MS patient exhibited obstructions to their CSF flow when examined by phase coded CSF cinematography (ciné) in the upright position (Table 2A, col. 10 & 13).
All MS patients exhibited CSF flow abnormalities that were manifest on MR cinematography as interruptions to flow or outright flow obstructions somewhere in the cervical spinal canal,depending on the location and extent of their cervical spine pathology (Table 2A, col.
10, 11 & 13). Normal examinees did not display these flow obstructions (Table 2B, col.10 & 11).

full paper: http://www.fonar.com/pdf/PCP41_damadian.pdf