Venous variations of the brain and cranial vault

Burrows, Patricia E.; Konez, Orhan; Bisdorff, Annouk

doi:10.1016/s1052-5149(02)00061-8

Cited by 23 publications

(12 citation statements)

References 33 publications

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“…The extra-cranial venous system is complex as compared to the peripheral venous system, not well-examined and only partially understood [3,4]. It is a complex three-dimensional (3D) structure that is often asymmetric and represents significantly more variability than extra-cranial arterial anatomy.…”

Section: Introductionmentioning

confidence: 99%

The role of noninvasive and invasive diagnostic imaging techniques for detection of extra-cranial venous system anomalies and developmental variants

Dolić

Siddiqui

Karmon

et al. 2013

BMC Med

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The extra-cranial venous system is complex and not well studied in comparison to the peripheral venous system. A newly proposed vascular condition, named chronic cerebrospinal venous insufficiency (CCSVI), described initially in patients with multiple sclerosis (MS) has triggered intense interest in better understanding of the role of extra-cranial venous anomalies and developmental variants. So far, there is no established diagnostic imaging modality, non-invasive or invasive, that can serve as the “gold standard” for detection of these venous anomalies. However, consensus guidelines and standardized imaging protocols are emerging. Most likely, a multimodal imaging approach will ultimately be the most comprehensive means for screening, diagnostic and monitoring purposes. Further research is needed to determine the spectrum of extra-cranial venous pathology and to compare the imaging findings with pathological examinations. The ability to define and reliably detect noninvasively these anomalies is an essential step toward establishing their incidence and prevalence. The role for these anomalies in causing significant hemodynamic consequences for the intra-cranial venous drainage in MS patients and other neurologic disorders, and in aging, remains unproven.

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Section: Introductionmentioning

confidence: 99%

The role of noninvasive and invasive diagnostic imaging techniques for detection of extra-cranial venous system anomalies and developmental variants

Dolić

Siddiqui

Karmon

et al. 2013

BMC Med

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“…The aspiration effect of the blood is a consequence of the negative pressure of the pleural cavity; it accounts for approximately Ϫ3 cmH 2 O in respect to the atmospheric pressure and represents a gradient facilitating the return of the blood toward the right atrium. The gradient can be further increased to Ϫ8 cmH 2 O by deep inspiration (5,17). Such a mechanism is particularly relevant in supine posture, because upright, the cerebral blood return is further facilitated by the gravitational effect, mainly via the vertebral venous system (8,17,21).…”

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confidence: 99%

Does thoracic pump influence the cerebral venous return?

Zamboni

Menegatti

Pomidori³

et al. 2012

Journal of Applied Physiology

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We assessed the hemodynamic effects induced by the thoracic pump in the intra- and extracranial veins of the cerebral venous system on healthy volunteers. Activation of the thoracic pump was standardized among subjects by setting the deep inspiration at 70% of individual vital capacity. Peak velocity (PV), time average velocity (TAV), vein area (VA), and flow quantification (Q) were assessed by means of echo color Doppler in supine posture. Deep respiration significantly increases PV, TAV, and Q, but it is limited to the extracranial veins. To the contrary, no significant hemodynamic changes were recorded at the level of the intracranial venous network. Moreover, at rest TAV in the jugular veins was significantly correlated with Q of the intracranial veins. We conclude that the modulation of the atmospheric pressure operated by the thoracic pump significantly modifies the hemodynamics of the jugular veins and of the reservoir of the neck and facial veins, with no effect on the vein network of the intracranial compartment.

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“…Finally, SP has been reported in association with several malformations and syndromes, as shown in Table 3. 5,6,9,10,16,17,24,26,27,31,32,47,50 The natural history of SP is not clearly understood. Although SP is generally considered benign, the outcome may not be predicted easily.…”

Section: Discussionmentioning

confidence: 99%

Sinus pericranii: diagnosis and management in 21 pediatric patients

Pavanello¹,

Melloni²,

Antichi

et al. 2015

PED

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OBJECT Sinus pericranii (SP) is a rare venous anomaly abnormally connecting the intracranial dural sinuses with the epicranial veins. In the present study the authors aimed to clarify this clinicoradiological entity, define the role of angiography in its preoperative assessment, and suggest a diagnostic-therapeutic flow chart for management purposes. METHODS The authors retrospectively reviewed the clinical charts and neuroimages of 21 patients with SP. All patients underwent brain MRI, MR venography, and craniocerebral CT. Diagnostic digital subtraction angiography was performed in 19 of 21 patients, and the SPs were categorized as dominant (draining the majority of the intracranial venous outflow) or accessory (draining only a minority of the intracranial venous outflow). RESULTS SP was median or paramedian in 20 patients and lateral in 1 patient. There were 5 dominant and 14 accessory SPs. The dominant SPs were not treated. Among the patients with accessory SP, 4 were not treated, 2 underwent surgical ligature, and 8 were treated endovascularly (with either transvenous or percutaneous embolization). No complications were observed, and symptoms disappeared after treatment in all cases. CONCLUSIONS Accepted guidelines or recommendations concerning the management, diagnosis, and treatment of SP are still lacking. The authors define here a diagnostic-therapeutic flow chart, in which angiography plays a crucial role in the classification of SP and choice of the optimal treatment. Only accessory SP is amenable to treatment, whereas dominant SP must be preserved. The endovascular approach is becoming increasingly relevant and has proven to be safe and effective.

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Venous variations of the brain and cranial vault

Cited by 23 publications

References 33 publications

The role of noninvasive and invasive diagnostic imaging techniques for detection of extra-cranial venous system anomalies and developmental variants

The role of noninvasive and invasive diagnostic imaging techniques for detection of extra-cranial venous system anomalies and developmental variants

Does thoracic pump influence the cerebral venous return?

Sinus pericranii: diagnosis and management in 21 pediatric patients

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