The Oscillating Component of the Internal Jugular Vein Flow: The Overlooked Element of Cerebral Circulation

Sisini, Francesco; Toro, Eleuterio F.; Gambaccini, M.; Zamboni, Paolo

doi:10.1155/2015/170756

Cited by 18 publications

(15 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, we found higher venous pulsatility in jugular veins than in sinuses in both groups (Table 1). In our opinion, the main origin of blood pulsatility in cerebral veins and sinuses is the cardiac aspiration when the tricuspid valve is opened, as also pointed out previously [35,36].…”

Section: Changes In Intra-and Extracranial Venous Cerebral Blood Flowsupporting

confidence: 73%

Extracranial versus intracranial hydro-hemodynamics during aging: a PC-MRI pilot cross-sectional study

Lokossou

Metanbou

Gondry-Jouet

et al. 2020

Fluids Barriers CNS

View full text Add to dashboard Cite

Background: Both aging and changes in blood flow velocity between the extracranial (intraspinal) and intracranial regions of cerebral vessels have an impact on brain hydro-hemodynamics. Arterial and venous cerebral blood flows interact with cerebrospinal fluid (CSF) in the both the cranial and spinal systems. Studies suggest that increased blood and CSF flow pulsatility plays an important role in certain neurological diseases. Here, we investigated the changes in blood-CSF flow pulsatility in the cranial and spinal systems with age as well as the impact of the intracranial compartment on flow patterns. Method: Phase-contrast magnetic resonance imaging (PC-MRI) was performed in 16 young and 19 elderly healthy volunteers to measure the flows of CSF and blood. CSF stroke volume (SV), blood SV, and arterial and venous pulsatility indexes (PIs) were assessed at intra-and extracranial levels in both samples. Correlations between ventricular and spinal CSF flow, and between blood and CSF flow during aging were also assessed. Results: There was a significant decrease in arterial cerebral blood flow and intracranial venous cerebral blood flow with aging. We also found a significant increase of intracranial blood SV, spinal CSF SV and arterial/venous pulsatility indexes with aging. In regard to intracranial compartment impact, arterial and venous PIs decreased significantly at intracranial level in elderly volunteers, while young adults exhibited decrease in venous PI only. Intracranial venous PI was paradoxically lower than extracranial venous PI, regardless of age. In both sample groups, spinal CSF SV and aqueductal CSF SV were positively correlated, and so were extracranial blood and spinal CSF SVs. Conclusion: The study demonstrates that aging changes blood flow but preserves blood and CSF interactions. We also showed that many parameters related to blood and CSF flows differ between young and elderly adults.

show abstract

Section: Changes In Intra-and Extracranial Venous Cerebral Blood Flowsupporting

confidence: 73%

Extracranial versus intracranial hydro-hemodynamics during aging: a PC-MRI pilot cross-sectional study

Lokossou

Metanbou

Gondry-Jouet

et al. 2020

Fluids Barriers CNS

View full text Add to dashboard Cite

show abstract

“…It is the consequence of the transmission along the veins of the atrial pressure generated by the cardiac pump in the veins of the upper part of the body. [34][35][36][37][38] Some authors compare the jugular pulsation to a barometer inserted into the atrium that measures the pressure variations in the cardiac atrium. The typical jugular venous pulse is characterized by a sequence of five waves, three positive (a, c, v) and two negative (x and y).…”

Section: Venous Compliance and Pulsatile Veinsmentioning

confidence: 99%

“…The typical jugular venous pulse is characterized by a sequence of five waves, three positive (a, c, v) and two negative (x and y). [34][35][36][37][38] When the atrium begins the contraction, signaled by the p wave of the ECG, there corresponds to the positive and higher a wave in the JVP (Figure 9). The negative peak x is the consequence of the lowering of the cardiac septum when the ventricles begin the contraction.…”

Section: Venous Compliance and Pulsatile Veinsmentioning

confidence: 99%

“…36,37 From the clip it is possible to assess something like 30 different CSA of the vein for each of the cardiac cycle. The variations of the area correspond to the JVP and in fact the ultrasonic JVP nicely reproduces the waves sequence above described, permitting also from proper calculations to assess haemodynamic parameters such as flow velocity, flow rate, gradient of pressure and venous compliance.…”

Section: Venous Compliance and Pulsatile Veinsmentioning

confidence: 99%

See 1 more Smart Citation

Venous compliance and clinical implications

Zamboni

Tavoni

Sisini

et al. 2018

Veins and Lymphatics

Self Cite

View full text Add to dashboard Cite

Compliance is a characteristic of every deformable system. Compliance is very clear concept in physics and mechanics but in clinics, perhaps, is not the same. However, in veins compliance fits perfectly with the function of drainage of the venous system. Volumetric increase (dV) of the content is correlated with pressure increase (dP) inside the vein according to the equation C’= dV/dP. In humans 75% of the blood is located in the venous system, primarily because the molecular components of a vein media layer is significantly more compliant to that of arteries. This property is fundamental to understanding the change in blood volume in response to a change in posture. Measurements of venous compliance in clinical practice can be done by the means of ultrasound, as well as with the plethysmography. Ultrasound methods assimilate the cross sectional area to the volume of the vein, because it reflects the blood content. Changes in cross sectional area can be reliably measured in response to a change in posture, while pressure can be derived from the hydrostatic pressure changes. Venous compliance is of paramount importance also in pulsatile veins such as the inferior or superior vena cava and the jugular veins, where high resolution ultrasound may accurately derive the cross sectional area. Clinical implications of the mechanical properties of the venous wall are extensively discussed, including the need of dedicated venous stenting, which takes into account venous compliance as the main parameter of the venous function. In addition, venous compliance is the interpretative key for a better understanding of plethysmography curves, as well as of varicose veins and of their return to normal cross sectional area following ambulatory venous pressure reduction.

show abstract

“…In the present issue of Behavioural Neurology, Sisini et al propose a novel methodology based on the ultrasonographic assessment of the jugular venous pulse (US JVP) [ 44 ]. As reported above, they obtain ADW and JVP from high resolution ultrasound B-mode imaging, synchronized with the cardiac trace.…”

Section: Perspectivesmentioning

confidence: 99%

Why Current Doppler Ultrasound Methodology Is Inaccurate in Assessing Cerebral Venous Return: The Alternative of the Ultrasonic Jugular Venous Pulse

Zamboni

2016

Behavioural Neurology

Self Cite

View full text Add to dashboard Cite

Assessment of cerebral venous return is growing interest for potential application in clinical practice. Doppler ultrasound (DUS) was used as a screening tool. However, three meta-analyses of qualitative DUS protocol demonstrate a big heterogeneity among studies. In an attempt to improve accuracy, several authors alternatively measured the flow rate, based on the product of the time average velocity with the cross-sectional area (CSA). However, also the quantification protocols lacked of the necessary accuracy. The reasons are as follows: (a) automatic measurement of the CSA assimilates the jugular to a circle, while it is elliptical; (b) the use of just a single CSA value in a pulsatile vessel is inaccurate; (c) time average velocity assessment can be applied only in laminar flow. Finally, the tutorial describes alternative ultrasound calculation of flow based on the Womersley method, which takes into account the variation of the jugular CSA overtime. In the near future, it will be possible to synchronize the electrocardiogram with the brain inflow (carotid distension wave) and with the outflow (jugular venous pulse) in order to nicely have a noninvasive ultrasound picture of the brain-heart axis. US jugular venous pulse may have potential use in neurovascular, neurocognitive, neurosensorial, and neurodegenerative disorders.

show abstract

The Oscillating Component of the Internal Jugular Vein Flow: The Overlooked Element of Cerebral Circulation

Cited by 18 publications

References 30 publications

Extracranial versus intracranial hydro-hemodynamics during aging: a PC-MRI pilot cross-sectional study

Extracranial versus intracranial hydro-hemodynamics during aging: a PC-MRI pilot cross-sectional study

Venous compliance and clinical implications

Why Current Doppler Ultrasound Methodology Is Inaccurate in Assessing Cerebral Venous Return: The Alternative of the Ultrasonic Jugular Venous Pulse

Contact Info

Product

Resources

About