Clinically speaking, the types of cases in MS fall into definite, probable and possible categories. The definite cases are defined by areas of demyelination in the brain and cervical cord that show up as hyperintensity signals on scans. In the brain they are usually found in the supratentorial area above the covering over the cerebellum, which is in the bottom compartment of the cranial vault. Furthermore, they are more frequently found in the periventricular areas surrounding the upper chambers of the brain called ventricles. In other words, MS lesions are typically found in the upper compartments of the brain. In contrast to the brain, the lesions can also show up along the flanks of the outside of the cervical cord as opposed to its core. Barring hyperintensity signals, the diagnosis in all other cases of MS remains suspect until all other possibilities are ruled out.
Aside from supratentorial hyperintensity signals the only other significant clinical finding in MS is oligoclonal bands in cerebrospinal fluid taken from the cord. The bands come from gamma globulin breakdown, which is part of the immune system. This is why MS is oftentimes erroneously described as an immunological disease even though there is no solid evidence to substantiate this.
Dr. Zamboni attributes the source of CCSVI to stenosis of veins that the internal jugular veins drain into. Regarding the issue of stenosis, the first point of contention I have, is it that it is hard to imagine how stenosis in much lower cervical and thoracic veins can cause back pressure significant enough to cause the supratentorial periventricular lesions seen in the upper most compartments of the brain in cases with definite MS. If anything, you would expect to find the lesions around the veins in the bottom of the cranial vault. Secondly, it is also hard to explain how stenosis of cervical and thoracic veins cause the oligoclonal bands found in CSF. If it is due to blockage of cervical and thoracic veins causing back pressure against the cord, then there should be more demyelination in the cervical and thoracic cord, which drain into the cervical and thoracic veins as well. Lastly, considering the huge drainage capacity of the vertebral venous system, it is hard to imagine how stenosis of more distant cervical and thoracic veins can cause lesions of MS to show up along the flanks of the cervical cord.
This is just the tip of the iceberg. The role of venous drainage issues in neurodegenerative diseases is much larger than simply MS. I discuss it all in my book The Downside of Upright Posture – The Anatomical Causes of Alzheimer’s, Parkinson’s and Multiple Sclerosis. You can read more about the book on my website uprightdoc.com. Moreover, I think I have a better explanation as to the source of CCSVI, which I will discuss in future posts.