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J Appl Physiol (January 10, 2003). doi:10.1152/japplphysiol.00782.2002
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Submitted on August 26, 2002
Accepted on January 2, 2003

EXTRAJUGULAR PATHWAYS OF HUMAN CEREBRAL VENOUS BLOOD DRAINAGE - ASSESSED BY DUPLEX ULTRASOUND

Stephan J Schreiber1*, Frank Lurtzing1, Rainer Gotze1, Florian Doepp1, Randolf Klingebiel2, and Jose M Valdueza1

1 Department of Neurology, University Hospital Charite, Berlin, Germany
2 Neuroradiological Section of the Department of Radiology, University Hospital Charite, Berlin, Germany

* To whom correspondence should be addressed. E-mail: Stephan.Schreiber{at}charite.de.

Cerebral venous drainage in man is thought to be ensured mainly via the internal jugular veins (IJVs). However, anatomical, angiographic and ultrasound studies suggest that the vertebral venous system serves as an important alternative drainage route. We assessed venous blood volume flow (vBVF) in vertebral veins (VVs) and IJVs of 12 healthy volunteers using duplex ultrasound. Measurements were performed at rest, during a transient bilateral IJV and a circular neck compression. Total vBVF at rest was 766±226 ml/min (IJVs: 720±232, VVs: 47±33). During bilateral IJV compression VV flow increased to 128±64 ml/min. Circular neck compression, causing an additional deep cervical vein obstruction led to a further rise in VV volume flow (186±70 ml/min). As the observed flow increase did not compensate for IJV flow cessation, other parts of the vertebral venous system like the intraspinal epidural veins and the deep cervical veins have to be considered as additional alternative drainage pathways.




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