M EDI CI N E

lt|sbackin
thespoiligh
His findingsalteredperceptions
of MS.Now, zamboniandvariousexperrsare
discussingstandardsfor diagnosis-and
turningrrr.ir.y. to othervascular
diseases.
pAoI,o zAMBot,tt ts fi nally
relaxing in a chair Much of rhat wartage,predicrably.lallson
in his hotel roominBologna, Italy,leflecting . incendiary topic. The medical establishment
cerebrospinalvenous insufliciency has
on the long day ofrigorous researchpreseri- :llTi. shown resistanceand skepticism; many
(CCSVI),a conditionZamboniidentified that
tarions.all parrofthis week'sinauquralannual neurologists dismiss Zamboni's hlrrothesis
is characterizedby blockagesin the neck and
m e e t i ng of t he Inte rna tion al Soc iet vf or as spuriousand unproven.But that hasn't
chest veins. It was in this Italian city, in Sep_ prevented
NeurovascularDisease(ISN\D), ofwhich he an estimated 1o,o00 MS patients
tember ZoO9, that the former ,rur.rrlu, ,,rr_
is the president and mobilizing force. The from seekingrrearmenrat clinicsspringing
geon first publicly presented his research
gatheringof the new interclisciplinarygroup up internationally to meet demand.
linking CCSVIwirh multiple scierosis patienrs.
of scientists-among them var*lu,,u.!.o.rr, Meanwhile, as evident in Boloqna this
That. in itself,,wasn'r groundbreaking: vas_
interventionalradiologists. week,a CCSMcommuniryhasformed,mani_
physicists and a cular theoriesofMS predareits classific"ation
few neurologists-represenrs festing all ofthe tribal habits ofany new soci_
a freshf,ocuson as an autoimmune disorder.
the overlooked roie ofthe vascularsystemin \X/hat made ery.A peckingorder is unfolding.n lunguug.
headiines,and inspired rare hope amongMS
neurologicalcondirions.It's a timely endeav_ defined. Establishing consistenr rt".rdu.L
patienrs,was Zamboni's claim that aneio_
our,giventheagingpopulation. '.1thinkwe plasty to restore tor CCSW scanning and diagnosis was the
blood flow resulted in sriro_ firstmarterof
let in a lirtlenewlighr."thethoushtfuland toms business on day one.asthe 4o
abating, sometimes dramaticallv. founding members reached a consensuson
mild-mannered Italiandoctorsaysgently. Eighreenmonths later.CCSWisa hot. and protocols.
"There was a lot oftestosterone

MACLEAN' S MAGAZ IN E
o)
in the room," onewomanpresentobserved.
Overthenexttwodays,anaudience of more
than100listenedto 19research submissions
with suchtitlesas,"Hyperfusionof brain
parenchymain CCSVI"and"Riskfactorsin
vasculardementia."Much talk and debate
ensuedoverthe minutiaeof imagingmeth-
odologyand clinicalprotocols.
And new territory was forged. Zamboru
sayshewasbuoyedby repeatedfindingsthat
identifiedCCSVIin more than 90 per cent
of MSpatients. SanDiegoneurologist David
Hubbard announcedpreliminary findings
that quantifiedpositivepost-CCSVItreat-
ment results,the first clinical proof they
aren'tmerelya"placeboeffect."Albany,N.Y., Home away from home: TheelegantlondonhouseofSaifcadhafi, now occupiedbyprotesters
vascularsurgeonManish Mehta revealed
thefirstdouble-blindCCSVItredtmentstudy
of r5o patientsshowingmarked improve- HOME
mentsacrossmdasures rangingfrom mobil-
ity to qualityof life. PhysicistMark Haacke,
regardedhereasthe Picassoofstate-of-the-
art imaging, weighed in with blood-fiow
Crihs:
despots
edition
measurementanalysisthat providesclues \X/heredo oil-richprincesandpotentatesgowhen
to why somepeoplebenefitmorefrom CCS\rI
treatmentthanothers. they'reshoppingfor a safeEuropeanbolthole?
Themeetingwas all aboutbloodflow,both
literally andconceptually.Buffalo,N.Y.,neur- MOAMMARGADHAFImay preferliving in ovuned throughanof[shorecorporation.That
ologistRobertZivadinovobservedCCSVIis tentswhenhe visitsthe West,but his sonSaif didn'tstopprotesters ftom recentlypicketing
not uniqueto MS,a conceptechoedby other likesBritishred brick. I\2oo9, he plunked the house.In Gadhafi'scase,squatterswent
scientistsstudying vascularformation in down $18million for an eight-bedroomman- further and stormedhis manor on March 9,
neurodegenerative diseases-Park i nson's, sion in London'stony Hampsteadsuburb. renaming it "the embassyof rebel Llbya"
Alzheimer'sandALS.Imagingrevealedsimi- Gadhafi,like so many of his region'soil-rich beforereleasingpicturesof its "more cash
laritiesin MS and Parkinson'slesions,The princesandpdtentates, knowsthe valueofa than class"party-palacestylings.tess dra-
overalleffectwasRashomon-like, asfindings safebolthole in Europe'sbanking and retail matically,whentheemirofAbu Dhabiwanted
informedand conffadictedone another."I centre-regimechangesooftencomeswithout to enclose hisentfue160-hectare
estate,Ascot
feel like a kid in a candystore;there have warning.(Duringthe fust Gulf\Var,the Saudi Place,nearWindsorCastle,with atwo-metre-
beensomanydisclosures," Mehtasaid. royalfamilyboughtt0 homeson "billionaire's highbrickwall,outragedlocalresidents'asso-
Zamboniviewsthe ISNVDas"a genuine row,"BishopsAvenue.Justin case.) ciationstook him to court.
academicandculturalmovementdetermined Indeed,sizablechunksof the most exclu- In theend,thelikesof Gadhafiurd Mubarak
by peopleand by results."Boardmembers siveareasofthe British capitalhavebeen areawareowningpropertydoesn'tmeanyou
pay their own way,he says;there are few snappedup by the megarich of the Middle can sleepthere.Just askThailand'sformer
sponsors andnoneofthe high-rollerextrava- East,either asinvestmentsor for their per- PM, ThaksinShinawatra.The controversial
ganceseenat manymedicalmeetings. sonaluse.Theemirof Qatarshelledoutmore billionairespenta lot of time in his London
That may be, but booths set up outside than955million for a 20o-year-old fixer-upper penthouseafterbeingoustedin a 2005coup.
the presentationhall reflectthe emerging at 100Parklane.HisPM, andcousin,signed Then,whilehewason anAsianbusiness trip,
CCSWindustry.Oneof the meeting'sspon- up for a $6J-million-plus apartmentat aprime Britain revokedhisvisaandbannedhimfiom
sors,medicalimagingconglomerate Esaote newdevelopment,OneHyde Park,whichhe theUnitedKinsdom.parnrcrrrnrelr
International, is sellingthe $73,o00Echo is backingfinancially.The headof financein
Doppler,billed "the only productdesigned nearbySharjah,part of theUnitedArabEmir-
for the diagnosisof CCSVI."Another for ates,alsoboughta flat there.In 2009,a Saudi
SardPeripheralVasculardisplaysthe latest royalgotplanningpermission to knockthree
s
in angioplastyballoons. housesin Belgraviainto one $8o-million ry
F
Thefactthat there'spotentiallybig money "super home," completewith a two-storey
a
to be madehere, ironically, only reinforces below-grade complex.GamalMubarhk,son 6

theneedfor thekind ofdialogueanddebate ofEgypt'srecentlyoustedruler,alsoownsa d

evidentin this medievalItalian town this pieceof Belgravia,namely ahtrurious pied-

week:wemaynowbeinthe 21stcenturybut d-terrear z8 \Uilton Place.
mysteriesof the humanbodystill remainto Mubarak'shome,likeGadhafi'sandthose
be revealed. aNNEKlNGsroN rN BoLocNA of virtually all other rich foreignbuyers,is Ffeein styfe: Mubarak'sson'sU.K.pied-d-terre

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