Giovanni Malferrari
Marialuisa Zedde
Patrizio Prati

2014

An Ultrasound Atlas

Although the physiological mechanisms associated with cerebral-venous outflow are poorly understood, abnormalities of the venous system have been implicated in a variety of neurological disorders, including multiple sclerosis. This has raised intriguing questions about how to best evaluate the involvement of the venous system in those disorders. In 2009, it was proposed that abnormalities of the venous system called chronic cerebrospinal venous insufficiency (CCSVI) could be the cause or one of the causes of multiple sclerosis. In late 2010, the Italian Multiple Sclerosis Foundation funded a large Italian multicenter observational study (CoSMo) to evaluate the association between CCSVI and multiple sclerosis. Its results and confirming findings by different studies recently published do not support the role of CCSVI as a recognizable clinical condition that is causally related to the development or progression of MS. The rigorous ultrasound technology and methodology adopted in the CoSMo study was instrumental to provide a clear answer to people with and affected by multiple sclerosis.