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October 2013; 3 (5) Clinical and Ethical Challenges

Hydration status substantially affects chronic cerebrospinal venous insufficiency assessments

Claudiu I. Diaconu, Robert J. Fox, Alia Grattan, Alexander Rae-Grant, Mei Lu, Heather L. Gornik, Esther Soo H. Kim
First published October 3, 2013, DOI: https://doi.org/10.1212/CPJ.0b013e3182a78f15
Claudiu I. Diaconu
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (CID), Mellen Center for Multiple Sclerosis Treatment and Research (RJF, AR-G), Heart and Vascular Institute, Cardiovascular Medicine, Non-Invasive Vascular Laboratory (AG, HLG, ESHK), and Neurological Institute, Cerebrovascular Center (ML), Cleveland Clinic, Cleveland, OH.
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Robert J. Fox
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (CID), Mellen Center for Multiple Sclerosis Treatment and Research (RJF, AR-G), Heart and Vascular Institute, Cardiovascular Medicine, Non-Invasive Vascular Laboratory (AG, HLG, ESHK), and Neurological Institute, Cerebrovascular Center (ML), Cleveland Clinic, Cleveland, OH.
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Alia Grattan
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (CID), Mellen Center for Multiple Sclerosis Treatment and Research (RJF, AR-G), Heart and Vascular Institute, Cardiovascular Medicine, Non-Invasive Vascular Laboratory (AG, HLG, ESHK), and Neurological Institute, Cerebrovascular Center (ML), Cleveland Clinic, Cleveland, OH.
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Alexander Rae-Grant
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (CID), Mellen Center for Multiple Sclerosis Treatment and Research (RJF, AR-G), Heart and Vascular Institute, Cardiovascular Medicine, Non-Invasive Vascular Laboratory (AG, HLG, ESHK), and Neurological Institute, Cerebrovascular Center (ML), Cleveland Clinic, Cleveland, OH.
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Mei Lu
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (CID), Mellen Center for Multiple Sclerosis Treatment and Research (RJF, AR-G), Heart and Vascular Institute, Cardiovascular Medicine, Non-Invasive Vascular Laboratory (AG, HLG, ESHK), and Neurological Institute, Cerebrovascular Center (ML), Cleveland Clinic, Cleveland, OH.
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Heather L. Gornik
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (CID), Mellen Center for Multiple Sclerosis Treatment and Research (RJF, AR-G), Heart and Vascular Institute, Cardiovascular Medicine, Non-Invasive Vascular Laboratory (AG, HLG, ESHK), and Neurological Institute, Cerebrovascular Center (ML), Cleveland Clinic, Cleveland, OH.
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Esther Soo H. Kim
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (CID), Mellen Center for Multiple Sclerosis Treatment and Research (RJF, AR-G), Heart and Vascular Institute, Cardiovascular Medicine, Non-Invasive Vascular Laboratory (AG, HLG, ESHK), and Neurological Institute, Cerebrovascular Center (ML), Cleveland Clinic, Cleveland, OH.
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Citation
Hydration status substantially affects chronic cerebrospinal venous insufficiency assessments
Claudiu I. Diaconu, Robert J. Fox, Alia Grattan, Alexander Rae-Grant, Mei Lu, Heather L. Gornik, Esther Soo H. Kim
Neurol Clin Pract Oct 2013, 3 (5) 386-391; DOI: 10.1212/CPJ.0b013e3182a78f15

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Summary

We sought to determine the effect of hydration on the criteria for chronic cerebrospinal venous insufficiency (CCSVI), a proposed hypothesis for the etiology of multiple sclerosis (MS). Sixteen subjects (11 MS and 5 controls) were asked to fast overnight. The following morning, 2 CCSVI ultrasound examinations were performed: 1 in the mildly dehydrated state, and another 30–45 minutes after rehydrating with 1.5 L of Gatorade. Seven subjects fulfilled CCSVI criteria in the dehydrated state. Of these, 5 (71%) no longer fulfilled CCSVI criteria after rehydration. One additional subject met CCSVI criteria only after rehydration. Hydration status has a substantial effect on CCSVI criteria, suggesting that the sonographic findings of CCSVI may represent a physiologic rather than pathologic state.

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  • Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.

  • © 2013 American Academy of Neurology
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