ICP and CBF Regulation: A new Hypothesis to Explain the “Windkessel” Phenomenon

Anile, Carmelo; Ficola, A.; Fravolini, Mario Luca; Cava, M. La; Maira, Giulio; Mangiola, Annunziato

doi:10.1007/978-3-7091-6738-0_29

Cited by 8 publications

(8 citation statements)

References 5 publications

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“…According to the Monro-Kellie law, the sum of brain volume plus cerebro-spinal fluid (CSF), plus cerebral blood volume (CBV) always remains constant (Schaller, 2004). Therefore, an increase in venous pressure/volume determines a volume compensation achieved by changes in both extra-and intracellular cerebral fluid volume (Carmelo et al, 2002;Wey and Kontos, 1982). From this point of view, the assessment of the diameter of the III V is an important parameter, easy and rapid to assess by Bmode TCCS, for its being, interestingly, related to both CBV and CSF volume.…”

Section: Assessment Of Third Ventricle Diametermentioning

confidence: 99%

Doppler Haemodynamics of Cerebral Venous Return

Menegatti¹,

Zamboni

2008

CNR

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Physiologic functioning of the cerebrovenous system is indispensable for maintaining normal brain function. However, in contrast to the cerebroarterial system, the cerebral venous return is not routinely investigated. Combined high-resolution echo-colour-Doppler (ECD) and transcranial colour coded Doppler sonography (TCCS) represents an ideal method to investigate the haemodynamics of cerebral venous return. TCCS-ECD is noninvasive, repeatable, cost-effective and permits to investigate the cerebral venous outflow in its dependence upon changes in posture and the alternating pressure gradients of the thoracic pump. Several authors reported normal parameters concerning related aspects of cerebral venous return. However, there is no ECD-TCCS standardization of what can be considered a normal venous return. The authors have summarized the current knowledge of the Doppler haemodynamics of the cerebrovenous system and propose a list of reproducible clinical parameters for its sonographic evaluation. In future, the development of this diagnostic technique could be of singular interest in iron-related inflammatory and neurodegenerative disorders like multiple sclerosis.

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Section: Assessment Of Third Ventricle Diametermentioning

confidence: 99%

Doppler Haemodynamics of Cerebral Venous Return

Menegatti¹,

Zamboni

2008

CNR

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“…An elevation of the ICP therefore appears to interfere with image quality and especially with the analysis of small, subsegmental vessels, and to lower diagnostic confidence. This may in parts be a consequence of a reduced cerebral blood flow and an increasing constriction of the cerebral arteries in the situation of an elevated ICP [15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Prospective, multireader evaluation of image quality and vascular delineation of multislice CT angiography of the brain

Ertl‐Wagner¹,

Bruening²,

Blume

et al. 2005

Eur Radiol

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The aim of this prospective, multireader trial was to investigate image quality and vascular delineation of cranial multislice CT angiography (MSCTA) to identify strengths and weaknesses of the method. Sixty consecutive patients underwent standardized cranial MSCTA. The mean estimated effective dose was 0.96+/-0.11 mSv. Three masked readers independently graded image quality parameters and vascular delineation on a 5-point scale. Vascular attenuation values and dose-length products were assessed quantitatively. Quantitative parameters were evaluated with a proportional odds regression model with bootstrapped standard errors to adjust the relevant standard errors for correlation within subjects and across readers. The non-parametric Wilcoxon sign-rank test was applied for quantitative measurements. Good to excellent ratings were observed regarding image quality parameters and vascular delineation. The delineation of veins was rated higher than that of arteries (OR 2.00). Smaller arterial segments were rated significantly less favorably than larger segments (OR up to 26.98). Moreover, the cavernous sinus, the C2 segment of the ICA and the communicating arteries demonstrated lower scores. Attenuation values were >240 HU and vessel-to-parenchyma ratios >7 in all vessels. Cranial MSCTA achieved high ratings regarding image quality and vascular delineation. Relative weaknesses were found in small arterial subsegments and in vessels in close topographical proximity to bone.

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“…Although we made this comment according to mean±std error values, we observed that the pressures continued to increase in particular rats in the Kaolin groups. This observation can be explained by impaired cerebral autoregulation secondary to persistent high intracranial pressure and shifting the compensatory phase to the decompensatory phase (1,3,5,14). The damaged Windkessel phenomenon that provides and maintains constant blood flow to arterioles and capillaries during diastole under normal conditions may be attributed to this unwilling process (3,5).…”

Section: Kaolin Frontalmentioning

confidence: 99%