The Venous Drainage of the Brain, With Special Reference to the Galenic System

Schlesinger, Bernard

doi:10.1093/brain/62.3.274

Cited by 126 publications

(54 citation statements)

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“…Furthermore, many of the vessels chosen for analysis in this work are located on the pial surface of the brain, which drain superficially from cortical tissue; 33 whereas the WM and deep GM structures drain medially into the internal cerebral veins and straight sinus. 34 This study found only a weak relationship between oxygenation and cortical thickness, but not with other MRI metrics of structural tissue damage. However, the finding of a negative correlation between OEF and EDSS is consistent with the positive correlation between oxygen saturation and EDSS previously identified by Ge et al 17 Both studies suggest that patients with reduced oxygen extraction in the cortex tend to have higher clinical disability.…”

Section: Physiologic Interpretation Of Findingscontrasting

confidence: 56%

Quantitative Oxygen Extraction Fraction from 7-Tesla MRI Phase: Reproducibility and Application in Multiple Sclerosis

Fan

Govindarajan

Kinkel

et al. 2014

J Cereb Blood Flow Metab

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Quantitative oxygen extraction fraction (OEF) in cortical veins was studied in patients with multiple sclerosis (MS) and healthy subjects via magnetic resonance imaging (MRI) phase images at 7 Tesla (7 T). Flow-compensated, three-dimensional gradient-echo scans were acquired for absolute OEF quantification in 23 patients with MS and 14 age-matched controls. In patients, we collected T2*-weighted images for characterization of white matter, deep gray matter, and cortical lesions, and also assessed cognitive function. Variability of OEF across readers and scan sessions was evaluated in a subset of volunteers. OEF was averaged from 2 to 3 pial veins in the sensorimotor, parietal, and prefrontal cortical regions for each subject (total of~10 vessels). We observed good reproducibility of mean OEF, with intraobserver coefficient of variation (COV) = 2.1%, interobserver COV = 5.2%, and scan-rescan COV = 5.9%. Patients exhibited a 3.4% reduction in cortical OEF relative to controls (P = 0.0025), which was not different across brain regions. Although oxygenation did not relate with measures of structural tissue damage, mean OEF correlated with a global measure of information processing speed. These findings suggest that cortical OEF from 7-T MRI phase is a reproducible metabolic biomarker that may be sensitive to different pathologic processes than structural MRI in patients with MS.

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Section: Physiologic Interpretation Of Findingscontrasting

confidence: 56%

Quantitative Oxygen Extraction Fraction from 7-Tesla MRI Phase: Reproducibility and Application in Multiple Sclerosis

Fan

Govindarajan

Kinkel

et al. 2014

J Cereb Blood Flow Metab

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“…23 In 1939 it was observed that retrograde pressure injections into the straight sinus resulted in perivenular extravasations of the fluid that closely simulated the distribution and the shapes of plaques in multiple sclerosis. 24 In the first pathological studies of MS plaques observers were divided as to whether MS plaques were always perivenular. The meticulous studies of Fog, 1965, put the matter to rest.…”

Section: Neuropathology Of Multiple Sclerosismentioning

confidence: 99%

Multiple Sclerosis - A Vascular Etiology?

Weir

2010

Can. j. neurol. sci.

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There has been a recent resurgence of interest in the possibility that cerebrospinal venous outflow obstruction, venous hypertension, development of collateral channels and flow reversal might be the primary inciting factor(s) for multiple sclerosis (MS). 1 The evidence should be considered bearing in mind Hill's criteria for causation as outlined by Giovannoni and Cutter: consistency and unbiasedness of findings, strength of association, temporal sequence, biological gradient, specificity, coherence of biological background and previous knowledge, biological plausibility, reasoning by analogy and experimental evidence.2 At the present state of our knowledge, despite monumental efforts, the cause is unknown. Anatomy Of Venous Outflow From The Brain And Spinal CordCapillaries drain into venules (10 -20 µ) that combine, almost at right angles to form larger venules within the grey matter. At a size of 50 -100 µ the venules lead on to the cortical surface at right angles to it. At the surface they combine in a two dimensional network. The craniospinal venous system is valveless and consists of veins and plexuses whose flow is potentially bidirectional. The superior cortical cerebral veins drain rostrally into the superior sagittal sinus. The inferior lateral ABSTRACT: From the earliest pathological studies the perivenular localization of the demyelination in multiple sclerosis (MS) has been observed. It has recently been suggested that obstructions to venous flow or inadequate venous valves in the great veins in the neck, thorax and abdomen can cause damaging backflow into the cerebral and spinal cord circulations. Paolo Zamboni and colleagues have demonstrated abnormal venous circulation in some multiple sclerosis patients using non-invasive sonography and invasive venography. Furthermore, they have obtained apparent clinical improvement or stabilization by endovascular ballooning of points of obstruction in the great veins in some, at least temporarily. If non-invasive observations by others validate their initial observations of a significantly increased prevalence of venous obstructions in MS then trials of angioplasty/stenting would be justified in selected cases in view of the biological plausibility of the concept.RÉSUMÉ: Étiologie vasculaire de la sclérose en plaques. La localisation périveineuse de la démyélinisation a été observée dès les premières études anatomopathologiques sur la sclérose en plaques (SP). L'obstruction du flux veineux ou la présence de valves veineuses inadéquates dans les grandes veines du cou, du thorax et de l'abdomen pourraient causer un reflux dommageable à la circulation cérébrale et la moelle épinière selon une hypothèse récente. Paolo Zamboni et ses collègues ont démontré la présence d'une circulation veineuse anormale chez certains patients atteints de SP au moyen l'échographie non effractive et de la veinographie effractive. De plus ils auraient obtenu une amélioration clinique ou une stabilisation de l'état des patients par dilatation endovasculaire de points d'obstruction d...

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“…Noninvasive venography and image-guidance have evolved considerably during this study interval, and several authors have recently reported the utility of these modalities in surgical planning. 13,16 Our study provides additional perspective for neurosurgeons performing this surgical approach in children.…”

Section: Discussionmentioning

confidence: 85%

“…Acutely elevated venous pressure has been shown to cause a number of changes, including decreased capillary perfusion pressure, increased cerebral blood volume, disruption of the blood-brain barrier, decreased cerebral blood flow, cytotoxic edema, vasogenic edema, and venous thrombosis. 3,5,11,13 The intraoperative sacrifice of cortical bridging veins typically does not lead to venous infarction because the absence of valves within cerebral veins allows free communication between the superficial and deep venous drainage systems. 13 The recruitment of collateral venous drainage pathways occurs during the early phase of venous occlusion.…”

Section: Discussionmentioning

confidence: 99%

“…3,5,11,13 The intraoperative sacrifice of cortical bridging veins typically does not lead to venous infarction because the absence of valves within cerebral veins allows free communication between the superficial and deep venous drainage systems. 13 The recruitment of collateral venous drainage pathways occurs during the early phase of venous occlusion. The severity of the venous circulatory disturbance depends on the availability of individual venous collaterals.…”

Section: Discussionmentioning

confidence: 99%

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Incidence of venous infarction after sacrificing middle-third superior sagittal sinus cortical bridging veins in a pediatric population

McNatt¹,

Sosa²,

Krieger³

et al. 2011

PED

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Object The interhemispheric transcallosal approach offers an excellent surgical corridor for the treatment of deep-seated midline lesions. The approach typically requires the sacrifice of one or more middle-third superior sagittal sinus (SSS) cortical bridging veins, which introduces the risk of venous infarction and associated neurological injury. The authors studied the incidence of venous infarcts following this operative approach in a pediatric population. Methods The authors performed a retrospective review of surgical cases involving pediatric patients treated at the Children's Hospital Los Angeles between 1990 and 2007, in which an interhemispheric transcallosal operative procedure was performed and one or more middle-third SSS cortical bridging veins were occluded. Postoperative MR imaging studies done 1–3 days following the procedure were analyzed and compared with preoperative studies. Results Sixty-three patients met the inclusion criteria. No patient developed MR imaging evidence of venous infarction. Conclusions The occlusion of one or more middle-third SSS cortical bridging veins related to the interhemispheric transcallosal approach resulted in no incidence of cerebral venous infarction in this pediatric population.

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The Venous Drainage of the Brain, With Special Reference to the Galenic System

Cited by 126 publications

References 0 publications

Quantitative Oxygen Extraction Fraction from 7-Tesla MRI Phase: Reproducibility and Application in Multiple Sclerosis

Quantitative Oxygen Extraction Fraction from 7-Tesla MRI Phase: Reproducibility and Application in Multiple Sclerosis

Multiple Sclerosis - A Vascular Etiology?

Incidence of venous infarction after sacrificing middle-third superior sagittal sinus cortical bridging veins in a pediatric population

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