J. Valdueza
Neurological Center, Segeberger Kliniken – Bad Segeberg, Germany
The cerebral venous outflow has been neglected for many years in neurology. Considering Neurosonology a first interest started with primarily venous disorders, e.g. cerebral venous and sinus thrombosis. In the last few years venous ultrasound analysis was performed in a variety of other neurological disorders like dural fistulas, transient global amnesia and even in acute arterial stroke. In multiple sclerosis a chronic impaired cerebral venous outflow has claimed to be the starting point of a cascade leading to the disease. This concept has not been reproduced by groups with a longstanding experience in venous duplex sonography. However, the debates increased the scientific interest on the venous side of the cerebral circulation and its outflow.
Aim of the lecture is 1) to present the main principles of the cerebral venous outflow (postural dependency, intraspinal venous system route, intracranial valveless, extracranial internal jugular valve, right-sided predominance of outflow), 2) to give an overview about the ultrasound examination of the extracranial and intracranial venous vessels using color-coded duplex sonography, and, 3) to show clinical implications.
Key words: brain venous system, clinical implications, neurosonography.