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Neurol Clin Pract. 2013 Oct;3(5):386-391.

Hydration status substantially affects chronic cerebrospinal venous insufficiency assessments.

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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.


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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