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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
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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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