Relationship between Intracranial and Sagittal Sinus Pressure in Normal and Hydrocephalic Dogs

1988 ◽  
Vol 14 (4) ◽  
pp. 196-201 ◽  
Author(s):  
W.C. Olivero ◽  
H.L. Rekate ◽  
H.J. Chizeck ◽  
W. Ko ◽  
J.M. McCormick
Keyword(s):  
Sagittal Sinus ◽  
Sagittal Sinus Pressure ◽  
Sinus Pressure

Dural posterior fossa AVM producing raised sagittal sinus pressure

1977 ◽  
Vol 46 (6) ◽  
pp. 804-810 ◽  
Author(s):  
Eduardo Lamas ◽  
Ramiro D. Lobato ◽  
Javier Esparza ◽  
Luis Escudero
Keyword(s):  
Intracranial Pressure ◽  
Posterior Fossa ◽  
Considerable Increase ◽  
Selective Embolization ◽  
Content Type ◽  
Sagittal Sinus ◽  
Arterial Blood ◽  
Sagittal Sinus Pressure ◽  
Dural Avm ◽  
Sinus Pressure

✓ A patient with raised intracranial pressure secondary to a dural arteriovenous malformation (AVM) of the posterior fossa is presented. Direct shunting of arterial blood into the transverse sigmoid sinus caused a considerable increase of the sagittal sinus pressure (SSP) and elevation of intracranial pressure (ICP). Both ICP and SSP returned to normal values following obliteration of the dural AVM by selective embolization.

Pressure in the sagittal sinus during intracranial hypertension in man

1974 ◽  
Vol 40 (5) ◽  
pp. 603-608 ◽  
Author(s):  
Albert N. Martins ◽  
Arthur I. Kobrine ◽  
Douglas F. Larsen
Keyword(s):  
Brain Tumors ◽  
Intracranial Hypertension ◽  
Cerebral Blood Volume ◽  
Content Type ◽  
Sagittal Sinus ◽  
Sagittal Sinus Pressure ◽  
The Mean ◽  
The Difference ◽  
Spatial Compensation ◽  
Sinus Pressure

✓ Intracranial pressure (ICP) and sagittal sinus pressure (SSP) were measured simultaneously in 12 patients with brain tumors and secondary intracranial hypertension (ICH). In nine, the mean SSP was largely unaffected by changes in ICP. In three, SSP changed with the ICP. In all but one patient, the ICP remained higher than SSP and, as the ICP increased, the difference between the two also increased. Sinograms performed during ICH demonstrated partial collapse of the sinuses in some patients and not in others. The mean SSP in adults with brain tumors appears to respond unpredictably to changes in ICP. Since the rate of cerebrospinal fluid drainage depends upon the gradient between ICP and SSP, intracranial spatial compensation is probably influenced by the response of SSP to ICP. Individuals with gradients that rapidly increase because their sinuses do not collapse probably compensate more rapidly than those whose sinuses do collapse. This assumed difference in the rate of spatial compensation may account for some of the variability of the ICP response to an enlarging intracranial mass or a change in cerebral blood volume.

scholarly journals Coupling of CSF and sagittal sinus pressure in adult patients with pseudotumour cerebri

2019 ◽  
Vol 162 (5) ◽  
pp. 1001-1009 ◽  
Author(s):  
Afroditi-Despina Lalou ◽  
Marek Czosnyka ◽  
Zofia H. Czosnyka ◽  
Deepa Krishnakumar ◽  
John D. Pickard ◽  
...  
Keyword(s):  
Venous Pressure ◽  
Fluid Pressure ◽  
Venous Drainage ◽  
Infusion Test ◽  
Pseudotumour Cerebri ◽  
Sagittal Sinus ◽  
Sagittal Sinus Pressure ◽  
The Relationship ◽  
Symptoms And Signs ◽  
Sinus Pressure

Abstract Objective Pseudotumour cerebri syndrome (PTCS including idiopathic intracranial hypertension) is characterised by the symptoms and signs of raised cerebrospinal fluid pressure (CSFp) in the absence of ventricular dilatation or an intracranial mass lesion. Its aetiology is unknown in the majority of cases but there is much evidence for impaired CSF absorption. Traditionally, sagittal sinus pressure has been considered to be independent of CSF pressure in adults. However, the discovery of stenoses of intracranial venous sinuses and introduction of venous sinus stenting has highlighted the importance of the venous drainage in PTCS. In this study, we have explored the relationship between CSFp and SSp before and during a CSF infusion test and during CSF drainage. Materials and methods Ten patients (9 females:1 male) with PTCS underwent infusion studies in parallel with direct retrograde cerebral venography. Both SSp and CSFp were recorded at a baseline and during CSFp elevation in a course of a CSF infusion test. The drainage of CSF after the CSF infusion was performed in 7 patients. In 5 cases, jugular venous pressure was also measured. Results CSFp and SSp including their amplitudes correlated significantly and strongly both at baseline (R = 0.96; p = 0.001) and during infusion (R = 0.92; p = 0.0026). During drainage, this correlation was maintained until SSp reached a stable value, whereas CSFp continued to decrease. Conclusions In this series of ten patients with PTCS, CSFp and SSp were coupled, both at baseline and during infusion. The implications of such coupling for the calculation of CSF outflow resistance are discussed.

Changes in superior sagittal sinus pressure in children with head elevation, jugular venous compression, and PEEP

1986 ◽  
Vol 65 (2) ◽  
pp. 199-202 ◽  
Author(s):  
M. Sean Grady ◽  
Robert F. Bedford ◽  
T. S. Park
Keyword(s):  
Superior Sagittal Sinus ◽  
Venous Pressure ◽  
Air Embolism ◽  
Potential Hazard ◽  
Sagittal Sinus ◽  
Venous Compression ◽  
Head Elevation ◽  
Neurosurgical Patients ◽  
Sagittal Sinus Pressure ◽  
Sinus Pressure

✓ Air embolism is a potential hazard during craniotomy whenever intracranial venous pressure is subatmospheric. In order to better understand both the risk of air embolism and its treatment in neurosurgical patients, the authors have investigated the relationship of superior sagittal sinus pressure (SSP) to head position in 15 children and examined the effects of both jugular venous compression and positive end-expiratory airway pressure (PEEP) on SSP. Progressive head elevation significantly decreased mean SSP and, in five patients, SSP was less than 0 mm Hg at 90° torso elevation. A PEEP of 10 cm H2O was ineffective in significantly increasing SSP at any degree of head elevation, whereas bilateral internal jugular compression always caused a significant increase in SSP. The authors conclude that children are at risk for venous air embolism when undergoing suboccipital craniectomy in the sitting position because intracranial venous pressure is often subatmospheric when the head is elevated. Furthermore, maintaining PEEP does not appear to be a reliable treatment for increasing SSP, whereas bilateral internal jugular compression is effective.

Intracranial venous pressures under conscious sedation and general anesthesia

2017 ◽  
Vol 9 (10) ◽  
pp. 986-989 ◽  
Author(s):  
Daniel M S Raper ◽  
Thomas J Buell ◽  
Ching-Jen Chen ◽  
Dale Ding ◽  
Robert M Starke ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Transverse Sinus ◽  
Jugular Bulb ◽  
Venous Sinus ◽  
Pressure Gradients ◽  
Sagittal Sinus ◽  
Venous Outflow Obstruction ◽  
The Mean ◽  
The Relationship ◽  
Sinus Pressure

IntroductionVenous outflow obstruction has been implicated in the pathophysiology of a subset of patients with idiopathic intracranial hypertension (IIH), and venous sinus stenting (VSS) has emerged as an effective treatment. However, the effect of anesthesia on venous sinus pressure measurements is unpredictable. A more thorough understanding of the effect of the level of anesthesia on intracranial venous pressures might help to better define patients who might benefit most from stent placement.ObjectiveTo compare, in a retrospective cohort study, intracranial venous pressures measured under conscious (CS) sedation versus general anesthesia (GA) and to assess the relationship between anesthetic-dependent venous pressures and outcomes after VSS.MethodsWe performed a retrospective review of a prospectively maintained database to identify patients undergoing angiographic evaluation and VSS for intracranial venous stenosis. Mean venous pressures (MVPs) and trans-stenosis pressure gradients obtained under CS were compared with those measured under GA.ResultsThe maximal MVP was significantly lower under GA (19.8 mm Hg) than CS (21.9 mm Hg; p=0.029). The MVPs in the superior sagittal sinus, torcula, and transverse sinus were lower under GA, but were significantly higher in the sigmoid sinus and jugular bulb under GA (p<0.001). The mean trans-stenosis pressure gradient was also significantly lower under GA (8.6 mm Hg) than CS (12.1 mm Hg; p<0.001). Patients with a larger difference between maximum MVP under GA versus CS were more likely to have normalization of the MVP after VSS (p=0.0008).ConclusionsIntracranial venous pressures are markedly affected by GA. In order to obtain an accurate measurement of MVPs and trans-stenosis gradients, patients undergoing investigation for IIH should undergo cerebral angiography and venous manometry under CS, which provides more reliable data for outcomes after VSS.

Circulatory disturbance of the venous system during experimental intracranial hypertension

1973 ◽  
Vol 39 (6) ◽  
pp. 723-729 ◽  
Author(s):  
Kenzoh Yada ◽  
Yoku Nakagawa ◽  
Mitsuo Tsuru
Keyword(s):  
Venous Pressure ◽  
Drainage System ◽  
Venous Drainage ◽  
Systemic Blood Pressure ◽  
Content Type ◽  
Circulatory Disturbance ◽  
Sagittal Sinus ◽  
Flow Through ◽  
Sagittal Sinus Pressure ◽  
Respiratory Disturbance

✓ The venous drainage system during increased intracranial pressure (ICP) was studied in dogs. The ICP was gradually increased to the level of the systemic blood pressure while related arterial and venous pressures were monitored. The blood flow through the parasagittal intradural venous channels (lateral lacuna) was also measured to test the collapsibility of these vessels. The cortical venous pressure was constantly 50 to 200 mm H2O higher than the ICP regardless of the degree of elevation, while the sagittal sinus pressure remained at 50 to 75 mm H2O unless the central venous pressure was elevated by respiratory disturbance. Flow through the lateral lacuna decreased as the ICP was increased. The authors conclude that the low pressure in the sinus and the consistency of the walls of the lateral lacuna allow gradual stenosis of the lacuna during increased ICP.

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