We quantify the effect of internal-jugular vein function on intracranial venous haemodynamics, with particular attention paid to venous reflux and intracranial venous hypertension. Haemodynamics in the head and neck is quantified by computing the velocity, flow and pressure fields, and vessel cross-sectional area in all major arteries and veins. For the computations we use a global, closed-loop multi-scale mathematical model for the entire human circulation, recently developed by the first two authors. Validation of the model against in vitro and in vivo Magnetic Resonance Imaging (MRI) measurements have been reported elsewhere. Here, the circulation model is equipped with a sub-model for venous valves. For the study, in addition to a healthy control, we identify two venous-valve related conditions, namely valve incompetence and valve obstruction. A parametric study for subjects in the supine position is carried out for nine cases. It is found that valve function has a visible effect on intracranial venous haemodynamics, including dural sinuses and deep cerebral veins. In particular, valve obstruction causes venous reflux, redirection of flow and intracranial venous hypertension. The clinical implications of the findings are unknown, though they may relate to recent hypotheses linking some neurological conditions to extra-cranial venous anomalies.
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http://dx.doi.org/10.2174/1567202612666150807112357 | DOI Listing |
AJNR Am J Neuroradiol
January 2025
Department of Radiology (M.D.M.), Permanente Medical Group, Kaiser Permanente Medical Center Santa Clara, Santa Clara, California.
CSF-venous fistulas (CVFs) are a common and increasingly recognized type of spinal CSF leak. Most of these fistulas occur in the setting of spontaneous intracranial hypotension, though nonspontaneous cases have been described as well. In most instances, CVFs arise from the dome or neck of nerve root sleeve diverticula (also called meningeal diverticula).
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Emergency Medicine, All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, India.
Snakebites are critical medical emergencies that significantly contribute to emergency department visits during monsoon seasons. This case report details a patient who experienced simultaneous arterial and venous thrombosis of major intracranial vessels due to venom-induced consumptive coagulopathy. Additionally, the patient developed diffuse alveolar haemorrhage (DAH), highlighting the severe impact of these uncommon complications on prognosis.
View Article and Find Full Text PDFJ Cereb Blood Flow Metab
January 2025
Department of Applied Physics and Electronics, Umeå University, Umeå, Sweden.
Variations in cerebral blood flow and blood volume interact with intracranial pressure and cerebrospinal fluid dynamics, all of which play a crucial role in brain homeostasis. A key physiological modulator is respiration, but its impact on cerebral blood flow and volume has not been thoroughly investigated. Here we used 4D flow MRI in a population-based sample of 65 participants (mean age = 75 ± 1) to quantify these effects.
View Article and Find Full Text PDFCan Assoc Radiol J
January 2025
North York General Hospital, Toronto, ON, Canada.
The Canadian Association of Radiologists (CAR) Central Nervous System Expert Panel is made up of physicians from the disciplines of radiology, emergency medicine, neurosurgery, and neurology, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 24 clinical/diagnostic scenarios, a rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 55 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) for guidelines framework were used to develop 51 recommendation statements across the 24 scenarios.
View Article and Find Full Text PDFAJNR Am J Neuroradiol
January 2025
From Department of Neuroradiology (Niklas Lützen, Charlotte Zander, Horst Urbach), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany and Department of Neurosurgery (Jürgen Beck, Florian Volz, Katharina Wolf, Amir El Rahal), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
Type 2 CSF leaks are spinal lateral dural tears, causing spontaneous intracranial hypotension (SIH). They may be visualized with digital subtraction myelography (DSM), cone-beam CT (CBCT) myelography, energy-integrating detector or photon-counting CT myelography. A recently introduced ultrahigh-resolution cone-beam CT (UHR-CBCT) myelography has shown beneficial visualization of CSF-venous fistula, another cause of SIH.
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