A Preliminary Study of Neonatal Cranial Venous System by Color Doppler

Abstract

Aim. To present anatomic data in the ultrasound planes for the identification of the major veins and the venous sinuses in cerebrum and to establish the sonographic normal reference values for the visualization of vein vessels and vein sinuses and blood flow velocities. Methods. This study involved 55 healthy full-term neonates for transfontanellar color Doppler sonography. The imaging included both sagittal and coronal planes with LA332E probe, supplemented with PA240 probe as necessary. As low as reasonably achievable (ALARA) principle was obeyed, limiting Doppler exposure time and maximizing signal intensity by increasing gain rather than outputting transducer power settings. The output power was kept at a minimum level consistent with recording an adequate signal. Keeping the newborns in calm state, the total examination time which every neonate required was less than 5 min. All images were stored also in a workstation for further analysis. The description statistics and t-test for statistical analysis were used. Result. In all studied cases (100% cases), subependymal veins (SV), internal cerebral veins (ICV), Galen vein (GV), straight sinus (SS), superior sagittal sinus (SSS), and transverse sinuses (TS) were visualized. The visualization percentages of inferior sagittal sinus (ISS) or basal veins/Rosenthal veins (BV/RV) were lower than 100%. Based on vessel visualization percentage from high to low, the vessels were ordered as follows: SV, ICV, BV, SS, TS, ISS, and SSS. In SSS and TS, the pulsation percentage was 100%. The descending percentages of vessel pulsation were noted in SS, BV, ICV, and SV. On the basis of the mean of maximum velocities of the vessels from low to high, the vessels were ordered as follows: ISS, BV-L, BV-R, ICV-R, ICV-L, SV-L, SV-R, SSS, TS-L, TS-R, and SS. Conclusion. The measurements percent of visualization of cerebral deep veins was higher than the percent of cerebral venous sinuses. The pulsation percent of measurement and the velocities of cerebral venous sinuses were absolutely higher than the cerebral deep venous system. The pairs of vascular blood flow velocities were nonsignificantly different from one another.

Low frequency cerebral arterial and venous flow oscillations in healthy neonates measured by NeoDoppler

“…In neonates with birth weight less than 1,000 g, high-grade fluctuations in the internal cerebral vein have been related to an increased risk of intraventricular hemorrhage ( 24 ). Compared to previous reported values from the transverse and superior sagittal sinus ( 33 , 35 , 36 ), the current paper report lower values for venous CBF velocities, RI and PI, which is probably due to the lack of angle correction and measurement in different veins.…”

Reversal of blood flow in deep cerebral vein in preterm intraventricular hemorrhage: two case reports

“…Especially, PRF, which is mainly caused by a reversed A-wave, may be a more severe sign [11]. It has been well established that cerebral vein vessels, vein sinuses, and blood flow velocities can be visualized using Doppler sonography [16], with successful visualization of all reported cases and velocity measured in > 80% of cases (Right side: 85.45%, Left side: 89.09%). Intracranial venous pulsations increase as the flow runs from the periphery towards the central portion [17].…”

Doppler Ultrasound Flow Reversal in the Superior Sagittal Sinus to Detect Cerebral Venous Congestion in Vein of Galen Malformation

“…In the cerebral sinus, amplitude fluctuations up to a triphasic forward flow are more common. [21][22][23] These fluctuations correspond to the cardiac action and respiratory movements. 24 Recent advances in US technology allow the assessment of small cortical and medullary veins and analysis of intravascular flow even at low venous flow velocities.…”