Use of Phase-Contrast MRA to Assess Intracranial Venous Sinus Resistance to Drainage in Healthy Individuals

Fall, Sidy; Pagé, Gwénaël; Bettoni, Jérèmie; Bouzerar, R.; Balédent, O.

doi:10.3174/ajnr.a5013

Cited by 14 publications

(7 citation statements)

References 37 publications

(38 reference statements)

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“…The pressure drop through a vessel can be calculated using the Poiseuille equation. 11 Fall et al 12 used this equation, finding the normal resistance of the sagittal sinus to be 20.1 Pa/mL/s and the straight sinus to be 40.2 Pa/mL/s. Our method varies in 2 important ways from this article.…”

Section: Discussionmentioning

confidence: 99%

Differences in the Calculated Transvenous Pressure Drop between Chronic Hydrocephalus and Idiopathic Intracranial Hypertension

Bateman

2018

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Chronic hydrocephalus is associated with dilated ventricles despite a normal intracranial pressure. In idiopathic intracranial hypertension, the ventricles are normal despite an elevated intracranial pressure. This apparent paradox has largely remained unexplained. It is suggested that a pressure difference between the superficial and deep venous territories of the brain could account for the variation between the 2 diseases. The purpose of this paper is to investigate the cause of this pressure difference. MATERIALS AND METHODS: Using MR phase-contrast imaging, we calculated the hydraulic diameters of the sagittal and straight sinuses in 21 patients with hydrocephalus, 20 patients with idiopathic intracranial hypertension, and 20 age-matched controls. The outflow resistance of each sinus was estimated using the Poiseuille equation. The outflow pressure was estimated using the flow data. A smaller subset of the patients with hydrocephalus had these studies repeated after successful shunt insertion. RESULTS: In hydrocephalus, the sagittal sinuses were 21% smaller than those in controls (P Ͻ .001); the straight sinuses were not significantly different. In idiopathic intracranial hypertension, both sinuses were not significantly different from those of controls. The pressure drop from the sagittal sinus to the end of the straight sinus was elevated by 1.2 mm Hg in hydrocephalus (P ϭ .001) but not significantly different from that in controls in idiopathic intracranial hypertension. Shunt insertion dilated the sagittal sinuses in hydrocephalus, leaving them 18% larger than normal and eliminating the transvenous pressure change. CONCLUSIONS: There is a transvenous pressure difference in hydrocephalus that is absent in idiopathic intracranial hypertension. This difference is eliminated by shunt insertion. The findings may have a bearing on ventricular dilation.

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Section: Discussionmentioning

confidence: 99%

Differences in the Calculated Transvenous Pressure Drop between Chronic Hydrocephalus and Idiopathic Intracranial Hypertension

Bateman

2018

AJNR Am J Neuroradiol

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“…The horizontal red line indicates the pressure drop which must be exceeded for IIH to be induced [10]. The black line indicates the current linear model of Fall et al, which shows that regardless of flow rate, a pressure drop large enough to cause IIH would never be reached [12]. It is evident from Fig.…”

Section: Discussionmentioning

confidence: 87%

“…vessel resistance values [12]. This analysis assumed that the venous outflow resistance was constant, irrespective of the total cerebral blood flow.…”

Section: Introductionmentioning

confidence: 99%

The relationship between cerebral blood flow and venous sinus pressure: can hyperemia induce idiopathic intracranial hypertension?

Bateman

Barber

2021

Fluids Barriers CNS

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Background It has been shown that idiopathic intracranial hypertension (IIH) in children is associated with cerebral hyperemia, which induces an increase in cerebral venous pressure. The current literature suggests venous pressure scales with blood flow in a linear fashion, however, a linear relationship would not raise the pressure high enough to induce IIH. There is, however, some evidence to suggest that this relationship could be quadratic in nature. The purpose of this paper is to characterize the relationship between cerebral blood flow and the pressure drop across the cerebral venous system. Methods 10 CT venogram data sets were collected for this study, with 5 useable geometries created. Computational fluid dynamics (CFD) models were generated using these geometries, with 10 simulations conducted per patient. The flow rates tested ranged from 200 mL/min to 2000 mL/min. 3D pressure and velocity streamline distributions were created and analyzed for each CFD model, with pressure drops across the cerebral venous system determined. The effective and hydraulic diameters were determined at the superior sagittal sinus, transverse sinus and both proximal and distal sigmoid sinuses. Results A quadratic relationship between blood flow and sinus pressure was found, with correlations of 0.99 or above in all five patients. The presence of vortical blood flow was found to explain this trend, with fluid curl and pressure drop correlations being above 0.97. This suggests that the presence of high blood flow should be considered in the diagnostic workup of IIH. Conclusions The cerebral venous sinus blood flow and pressure response relationship are quadratic in nature, with the major cause of this being the degree of rotation induced in the flow. The elevated blood flow found in children with IIH can explain the increased ICP that is found, secondary to the increase in venous pressure that develops.

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“…To our knowledge, there are alterations in cerebral hemodynamics related to abnormal drainage in the cerebral venous sinus system. However, the cerebral venous sinus system is characterized by marked interindividual discrepancy in blood drainage patterns due to anatomic variations . One of the most commonly confusing anatomic variations is the difference in the size of the TSs found in almost 50% of people.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Hemodynamic Alterations in Cerebral Veins in Patients With Intracerebral Hemorrhage Using Duplex Color‐Coded Sonography

Jin

Feng

et al. 2018

J of Ultrasound Medicine

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Use of Phase-Contrast MRA to Assess Intracranial Venous Sinus Resistance to Drainage in Healthy Individuals

Abstract: Phase-contrast MRA is a noninvasive means of calculating the resistance to drainage of blood across the venous sinus tree. Our approach for resistance to drainage quantification may be of value in understanding alterations in the cerebral venous sinus drainage system.

Cited by 14 publications

References 37 publications

Differences in the Calculated Transvenous Pressure Drop between Chronic Hydrocephalus and Idiopathic Intracranial Hypertension

Differences in the Calculated Transvenous Pressure Drop between Chronic Hydrocephalus and Idiopathic Intracranial Hypertension

The relationship between cerebral blood flow and venous sinus pressure: can hyperemia induce idiopathic intracranial hypertension?

Assessment of Hemodynamic Alterations in Cerebral Veins in Patients With Intracerebral Hemorrhage Using Duplex Color‐Coded Sonography

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