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Monnier H, Owashi K, Liu P, Metanbou S, Capel C, Balédent O. Quantification of the Dynamics of the Vascular Flows in the Cerebral Arterial and Venous Trees. Biomedicines 2025; 13:1106. [PMID: 40426933 PMCID: PMC12109075 DOI: 10.3390/biomedicines13051106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2025] [Revised: 04/28/2025] [Accepted: 04/29/2025] [Indexed: 05/29/2025] Open
Abstract
Objective: Cerebral vascularization is made of the symmetrical arterial system, with muscular walls, and the venous system, more variable and dominated by sinuses and jugular veins. Factors like age and posture influence this network, complicating its study. Phase-contrast MRI is the gold standard for quantifying cerebral circulation. This study aimed to quantify the dynamics of the cerebral blood system using PC-MRI. Materials and Methods: Thirty-six healthy adults participated. Imaging was performed on a 3T MRI (Philips Achieva) in a supine position. Two slices were acquired: intracranial and extracranial. In-house software analyzed flow curves over a cardiac cycle. Each vessel's contribution was evaluated. Results: Extracranial venous drainage was categorized as jugular-dominant, equivalent, or peripheral-dominant. A similar classification applied intracranially. Intracranial flows showed low variability (5-9%), while extracranial venous flows, especially in the internal jugular veins, had higher variability (17-21%). Some extracranial veins were absent. Conclusions: There is significant venous heterogeneity in the extracranial region. PC-MRI enables the quantification of cerebral dynamics.
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Affiliation(s)
- Heimiri Monnier
- CHIMERE UR 7516, Jules Verne University of Picardy, 80000 Amiens, France
| | - Kimi Owashi
- CHIMERE UR 7516, Jules Verne University of Picardy, 80000 Amiens, France
- Medical Image Processing Department, CHU Amiens-Picardie University Hospital, 80000 Amiens, France
| | - Pan Liu
- CHIMERE UR 7516, Jules Verne University of Picardy, 80000 Amiens, France
- Medical Image Processing Department, CHU Amiens-Picardie University Hospital, 80000 Amiens, France
| | - Serge Metanbou
- Radiology Department, CHU Amiens-Picardie University Hospital, 80000 Amiens, France
| | - Cyrille Capel
- CHIMERE UR 7516, Jules Verne University of Picardy, 80000 Amiens, France
- Neurosurgery Department, CHU Amiens-Picardie University Hospital, 80000 Amiens, France
| | - Olivier Balédent
- CHIMERE UR 7516, Jules Verne University of Picardy, 80000 Amiens, France
- Medical Image Processing Department, CHU Amiens-Picardie University Hospital, 80000 Amiens, France
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Owashi KP, Liu P, Metanbou S, Capel C, Balédent O. Phase-contrast MRI analysis of cerebral blood and CSF flow dynamic interactions. Fluids Barriers CNS 2024; 21:88. [PMID: 39468704 PMCID: PMC11514974 DOI: 10.1186/s12987-024-00578-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 09/27/2024] [Indexed: 10/30/2024] Open
Abstract
BACKGROUND Following the Monro-Kellie doctrine, the Cerebral Blood Volume Changes (CB_VC) should be mirrored by the Cerebrospinal Fluid Volume Changes (CSF_VC) at the spinal canal. Cervical level is often chosen to estimate CB_VC during the cardiac cycle. However, due to the heterogeneity in the anatomy of extracranial internal jugular veins and their high compliance, we hypothesize that the intracranial level could be a better choice to investigate blood and cerebrospinal fluid (CSF) interactions. This study aims to determine which level, intracranial or extracranial, is more suitable for measuring arterial and venous flows to study cerebral blood and CSF dynamics interactions. METHODS The spinal CSF and cerebral blood flow measured at intracranial and extracranial levels were quantified using cine phase-contrast magnetic resonance imaging (PC-MRI) in 38 healthy young adults. Subsequently, CSF_VC and CB_VC were calculated, and by linear regression analysis (R2 and slope), the relationship between CB_VC at both levels and the spinal CSF_VC was compared. The differences between extracranial and intracranial measurements were assessed using either a paired Student's t-test or Wilcoxon's test, depending on the normality of the data distribution. RESULTS The CB_VC amplitude was significantly higher at the extracranial level (0.89 ± 0.28 ml/CC) compared to the intracranial level (0.73 ± 0.19 ml/CC; p < 0.001). CSF oscillations through the spinal canal do not completely balance blood volume changes. The R2 and the slope values obtained from the linear regression analysis between CSF and blood flows were significantly higher in magnitude for the intracranial CB_VC (R2: 0.82 ± 0.16; slope: - 0.74 ± 0.19) compared to the extracranial CB_VC (R2: 0.47 ± 0.37; slope: -0.36 ± 0.33; p < 0.001). Interestingly, extracranial CB_VC showed a greater variability compared to intracranial CB_VC. CONCLUSION Our results confirmed that CSF does not completely and instantaneously balance cerebral blood expansion during the cardiac cycle. Nevertheless, the resting volume is very small compared to the total intracranial volume. To our knowledge, this study is the first to demonstrate these findings using cerebral blood flow measured intracranially below the Circle of Willis. Additionally, our findings show that cerebral arterial and venous flow dynamic measurements during the cardiac cycle obtained by PC-MRI at the intracranial plane strongly correlate with CSF oscillations measured in the spinal canal. Therefore, the intracranial vascular plane is more relevant for analyzing cerebral blood and CSF interactions during the cardiac cycle compared to measurements taken at the cervical vascular level.
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Affiliation(s)
- Kimi Piedad Owashi
- Medical Image Processing Department, CHU Amiens-Picardie University Hospital, Amiens, France.
- CHIMERE UR 7516, Jules Verne University of Picardy, Amiens, France.
| | - Pan Liu
- Medical Image Processing Department, CHU Amiens-Picardie University Hospital, Amiens, France
- CHIMERE UR 7516, Jules Verne University of Picardy, Amiens, France
| | - Serge Metanbou
- Radiology Department, CHU Amiens-Picardie University Hospital, Amiens, France
| | - Cyrille Capel
- CHIMERE UR 7516, Jules Verne University of Picardy, Amiens, France
- Neurosurgery Department, CHU Amiens-Picardie University Hospital, Amiens, France
| | - Olivier Balédent
- Medical Image Processing Department, CHU Amiens-Picardie University Hospital, Amiens, France
- CHIMERE UR 7516, Jules Verne University of Picardy, Amiens, France
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Cardona JJ, Dumont AS, Iwanaga J, Tubbs RS. Influence of Morphological Changes on Dural Venous Sinuses Hemodynamics. J Magn Reson Imaging 2024. [PMID: 39212163 DOI: 10.1002/jmri.29590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 07/26/2024] [Indexed: 09/04/2024] Open
Affiliation(s)
- Juan J Cardona
- Department of Neurosurgery, Clinical Neuroscience Research Center, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Aaron S Dumont
- Department of Neurosurgery, Clinical Neuroscience Research Center, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Joe Iwanaga
- Department of Neurosurgery, Clinical Neuroscience Research Center, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurology, Clinical Neuroscience Research Center, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Clinical Neuroscience Research Center, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurology, Clinical Neuroscience Research Center, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
- University of Queensland, Brisbane, Queensland, Australia
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Wu Z, Zhang K, Zong C, Liu H, Wang Y, Xu Y, Gao Y. Enlarged Perivascular Space in the Basal Ganglia is Associated with Cerebral Venous Reflux in Patients with Recent Small Subcortical Infarction. Curr Neurovasc Res 2024; 21:123-130. [PMID: 38323610 DOI: 10.2174/0115672026299546240130092550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/24/2024] [Accepted: 01/22/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Research has linked enlarged perivascular spaces (EPVS) to cerebral venous reflux (CVR) in patients with hypertensive intracerebral hemorrhage, but it is unclear whether this association exists in recent small subcortical infarct (RSSI) patients. OBJECTIVE This study aimed to investigate the correlation between EPVS and CVR in patients with RSSI. METHOD This study included 297 patients, selected from patients with RSSI in the lenticulostriate artery admitted to the Department of Neurology of the First Affiliated Hospital of Zhengzhou University. CVR was assessed by time-of-flight magnetic resonance angiography (TOF-MRA). The relationship between EPVS and CVR was studied using multiple logistic regression analysis. RESULTS This study included patients with an average age of 59.84±12.27 years, including 201 males (67.7%). CVR was observed in 40 (13.5%) patients. Compared to the group without CVR, the proportions of male patients and patients with a history of smoking and drinking were higher in the CVR group. The proportions of high-grade EPVS in the centrum semiovale region [23 cases (57.5%) vs. 108 cases (42.0%), p =0.067] and the basal ganglia region [30 cases (75.0%) vs. 133 cases (51.8%), p =0.006] were higher in the CVR group. After multiple logistic regression analysis, high-grade EPVS in the basal ganglia region was still associated with CVR (OR, 2.68; 95% CI, 1.22-5.87;p=0.014). CONCLUSION In the population with RSSI, EPVS in basal ganglia is significantly associated with CVR, suggesting a close relationship between venous dysfunction and the formation of EPVS.
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Affiliation(s)
- Zhengrong Wu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ke Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ce Zong
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongbing Liu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanhong Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuming Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuan Gao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Valero-Moreno F, Pullen MW, Navarro-Martínez G, Ruiz-Garcia H, Domingo RA, Martínez JL, Suarez-Meade P, Damon A, Quiñones-Hinojosa A, Sandhu SJ, Tawk RG, Fox WC. Absence of the torcular, review of venous sinus anatomy, and the simplified dural sinus classification. Acta Neurochir (Wien) 2023:10.1007/s00701-023-05559-w. [PMID: 37014451 DOI: 10.1007/s00701-023-05559-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/08/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Classically, the torcular Herophili is described as the symmetric junction between the superior sagittal sinus (SSS), transverse sinuses (TSs), and straight sinus (SS). However, finding this pattern in practice is not standard. Anatomical variations are common, and different drainage patterns should be expected. Existing literature proposes highly detailed descriptions and classifications of this region. Still, a simplified and practical categorization is not available. METHODS We present an anatomical finding of the torcular Herophili discovered on a cadaveric dissection. Then, we conducted a retrospective study examining the 100 most recent cranial magnetic resonance venographies (MRVs) from the Mayo Clinic, labeling them with a new proposed dural sinus classification system. Images were initially classified by two authors and further validated by a board-certified neurosurgeon and a board-certified neuroradiologist from our institution. To measure consistency in image identification, two additional international neurosurgeons were asked to classify a subset of the same MRV images, and their answers were compared. RESULTS Of the MRV cohort, 33 patients were male and 67 were female. Their ages ranged from 18 to 86 years, with a mean of 47.35 years and a median of 49 years. Upon examination, 53 patients presented as confluent (53%), 9 as SSS divergent (9%), 25 as SS divergent (25%), 11 as circular (11%), and 2 as trifurcated (2%). The inter-rater reliability ranked very good; agreement between the two neurosurgeons was 83% (κ = 0.830, p < 0.0005). CONCLUSION The confluence of the venous sinuses is a highly variable anatomical area that is rarely evaluated with neuroimaging before surgery. The classic textbook configuration is not the rule. Using a simplified classification system may increase awareness and hopefully patient safety by preparing the physician for anatomical variations that they will encounter in a surgical or clinical scenario.
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Affiliation(s)
- Fidel Valero-Moreno
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Michael W Pullen
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | | | - Henry Ruiz-Garcia
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Ricardo A Domingo
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
| | | | - Paola Suarez-Meade
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Aaron Damon
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | | | - Sukhwinder Js Sandhu
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA
| | - Rabih G Tawk
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - W Christopher Fox
- Department of Neurological Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
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Indiran V, Sivakumar V, Kumaran R, Jagannathan K. Can occipital lobe bending, Gibraltar sign of superior sagittal sinus groove and jugular foramen dimensions predict transverse sinus dominance? Neuroradiol J 2023; 36:158-162. [PMID: 35727589 PMCID: PMC10034698 DOI: 10.1177/19714009221111086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Asymmetry between the transverse sinuses (TS) is quite common. We sought to test the possible hypothesis that certain anatomical features - namely, occipital lobe bending, Gibraltar sign of superior sagittal sinus groove (SSS) and jugular foramen (JF) dimensions - can predict dominance of the transverse sinuses on routine axial T1- and T2-weighted images. MATERIALS AND METHODS One hundred consecutively acquired combined MRI-MRV studies of brain were reviewed. On non-contrast axial T1WI, each reviewer assessed the occipital lobe bending, and Gibraltar sign of SSS groove; on axial T2-weighted images, JF dimensions were measured. TS cross-sectional area was measured on non-contrast sagittal 2-dimensional phase contrast MRV images and served as the reference standard. RESULTS Of the 51 subjects with right-dominant TS, 37 had occipital bending to the right side and 35 showed sloping of the Gibraltar sign to right side. Of the 18 subjects with left dominant TS, 10 had occipital bending to left side and 13 showed left-sided sloping of the Gibraltar sign. Of the 31 subjects with co-dominant TS, 15 had no occipital bending and 20 showed no sloping of the Gibraltar sign. Mean right and left JF dimensions were higher in the right and left dominant TS respectively with no significant differences in patients with co-dominant sinus (p < 0.02). CONCLUSION Right occipital bending had a good association with right TS dominance. The other two parameters- Gibraltar sign of superior sagittal sinus groove and jugular foramen dimensions - did not have a very good association with respect to TS dominance.
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Affiliation(s)
- Venkatraman Indiran
- Department of Radiodiagnosis, Sree Balaji Medical College and
Hospital, Chennai, India
- Consultant Radiologist, IVR Scans, Chennai, India
| | | | - R Kumaran
- Department of Radiodiagnosis, Velammal Medical College Hospital and
Research Institute, Madurai, India
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Whittle RS, Diaz-Artiles A. Gravitational effects on carotid and jugular characteristics in graded head-up and head-down tilt. J Appl Physiol (1985) 2023; 134:217-229. [PMID: 36476158 PMCID: PMC9870583 DOI: 10.1152/japplphysiol.00248.2022] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 11/23/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Altered gravity affects hemodynamics and blood flow in the neck. At least one incidence of jugular venous thrombosis has been reported in an astronaut on the International Space Station. This investigation explores the impact of changes in the direction of the gravitational vector on the characteristics of the neck arteries and veins. Twelve subjects underwent graded tilt from 45° head-up to 45° head-down in 15° increments in both supine and prone positions. At each angle, the cross-sectional area of the left and right common carotid arteries (ACCA) and internal jugular veins (AIJV) were measured by ultrasound. Internal jugular venous pressure (IJVP) was also measured by compression sonography. Gravitational dose-response curves were generated from experimental data. ACCA did not show any gravitational dependence. Conversely, both AIJV and IJVP increased in a nonlinear fashion with head-down tilt. AIJV was significantly larger on the right side than the left side at all tilt angles. In addition, IJVP was significantly elevated in the prone position compared with the supine position, most likely because of raised intrathoracic pressure while prone. Dose-response curves were compared with existing experimental data from parabolic flight and spaceflight studies, showing good agreement on an acute timescale. The quantification of jugular hemodynamics as a function of changes in the gravitational vector presented here provides a terrestrial model to reference spaceflight-induced changes, contributes to the assessment of the pathogenesis of spaceflight venous thromboembolism events, and informs the development of countermeasures.NEW & NOTEWORTHY Flow stasis and thrombosis have been identified in the jugular vein during spaceflight. We measured the area and pressure of the internal jugular vein and the area of the common carotid artery in graded head-up and head-down tilt. Experimental data are used to generate gravitational dose-response curves for the measured variables, demonstrating that jugular vein area and pressure exhibit a nonlinear response to altered gravity. Gravitational dose-response curves show good agreement with spaceflight and parabolic flight studies.
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Affiliation(s)
- Richard S Whittle
- Department of Aerospace Engineering, Texas A&M University, College Station, Texas
| | - Ana Diaz-Artiles
- Department of Aerospace Engineering, Texas A&M University, College Station, Texas
- Department of Kinesiology & Sport Management, Texas A&M University, College Station, Texas
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Au A, Jung J, Johnson MW, Baumal C, Daily MJ, Gomolin JE, Gupta RR, Rahimy E, Wu L, Sadda SR, Sarraf D. Henle Fiber Layer Hemorrhage in Macular Telangiectasia Type 2: Is Right Eye Dominance Coincidence or Consequence? Am J Ophthalmol 2022; 241:80-86. [PMID: 35469791 DOI: 10.1016/j.ajo.2022.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/29/2022] [Accepted: 04/06/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To summarize all reported cases of Henle fiber layer (HFL) hemorrhage in the absence of subretinal neovascularization (SRNV) in patients with macular telangiectasia type 2 (MacTel2) and to propose a mechanism for the right-sided predominance of this unique presentation. DESIGN Perspective. METHODS Collection, review, and analysis of all cases in the literature and in the authors' databases of HFL hemorrhage in MacTel2, including analysis of baseline and follow-up multimodal retinal imaging findings of selected cases. Elucidation of the complex interplay of systemic venous pressure with the deep retinal capillary plexus and hypothesis regarding the right-sided predilection of HFL hemorrhage complicating MacTel2. RESULTS Ten patients presented with a unilateral, characteristic radial macular hemorrhage within the HFL that affected only the right eye in all cases. Absence of SRNV was confirmed by fluorescein angiography and/or optical coherence tomography angiography. The hemorrhage resolved spontaneously in at least 7 of the 10 eyes. The HFL hemorrhage may plausibly be explained by dysfunction of the deep capillary plexus in MacTel2 combined with an acute rise in central venous pressure, for which the right side may be at increased risk. CONCLUSIONS HFL hemorrhage can complicate MacTel2 in the absence of SRNV, and the radial pattern of blood affecting only the right eye is remarkable. The right eye predominance may be multifactorial in etiology. Related factors may include the right-sided predilection of MacTel2 and/or increased right-sided dural sinus drainage related to normal anatomical variation.
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Xiong J, Wang H, Zhu Y, Zhou Y, Pang Y, Zhang L. The Right Internal Jugular at the Cricoid Cartilage Level May Represent the Optimal Central Vein Puncture Site in Pediatric Patients. Front Pediatr 2022; 10:833845. [PMID: 35273930 PMCID: PMC8901722 DOI: 10.3389/fped.2022.833845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 01/11/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Internal jugular vein puncture or cannulation is far more difficult in children compared with adults. Anthropometric measures of the internal jugular vein acquired by two-dimensional ultrasound are useful in the practice of puncture and catheterization. The aim of this study is to measure anthropometric parameters of bilateral internal jugular veins in children and to determine the best puncture site based on these parameters. MATERIALS A total of 107 pediatric patients undergoing elective operation were included. Ultrasound-visible evaluation of bilateral internal jugular veins was used to obtain the depth from skin, maximum antero-posterior diameter, and cross-sectional area at the levels of the superior border of thyroid cartilage and cricoid cartilage. Statistical analysis was performed using these anthropometric data and demographic variables of all studied pediatric patients, such as age, height, and weight. RESULTS A very weak correlation was noted between the depth, maximal antero-posterior diameter, and cross-sectional area of both internal jugular veins and the age, height, weight, and body surface index of all included children. All Pearson's R correlation coefficients were <0.45. The largest diameter and cross-sectional area were in the right internal jugular vein at the cricoid cartilage level (p < 0.01) followed by the left internal jugular vein at this level (p < 0.01). In addition, the internal jugular vein at the cricoid cartilage level was more superficial than that of the superior border of the thyroid cartilage (p < 0.01). CONCLUSION The right internal jugular vein at the cricoid cartilage level is the best site for puncture. The most appropriate alternative site is the left internal jugular vein on the same level. Better correlation was not observed between the anthropometric parameters of the internal jugular vein and children's biological characteristics. This finding should be confirmed in a larger-scale demographical study in the future.
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Affiliation(s)
- Jun Xiong
- Department of Anesthesiology, Shenzhen University General Hospital, Shenzhen University, Shenzhen, China
| | - Huijun Wang
- Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yun Zhu
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Yafen Zhou
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Yanan Pang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Liwei Zhang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, China
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Comparative evaluation of dural venous sinuses and cerebral veins using contrast-enhanced spoiled gradient recalled echo and time-of-flight magnetic resonance venography. JOURNAL OF CONTEMPORARY MEDICINE 2019. [DOI: 10.16899/jcm.556044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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11
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Vascular effects on the BOLD response and the retinotopic mapping of hV4. PLoS One 2019; 14:e0204388. [PMID: 31194745 PMCID: PMC6563965 DOI: 10.1371/journal.pone.0204388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 05/29/2019] [Indexed: 11/30/2022] Open
Abstract
Despite general acceptance that the retinotopic organisation of human V4 (hV4) takes the form of a single, uninterrupted ventral hemifield, measured retinotopic maps of this visual area are often incomplete. Here, we test hypotheses that artefact from draining veins close to hV4 cause inverted BOLD responses that may serve to obscure a portion of the lower visual quarterfield—including the lower vertical meridian—in some hemispheres. We further test whether correcting such responses can restore the ‘missing’ retinotopic coverage in hV4. Subjects (N = 10) viewed bowtie, ring, drifting bar and full field flash stimuli. Functional EPIs were acquired over approximately 1.5h and analysed to reveal retinotopic maps of early visual cortex, including hV4. Normalised mean maps (which show the average EPI signal amplitude) were constructed by voxel-wise averaging of the EPI time course and used to locate venous eclipses, which can be identified by a decrease in the EPI signal caused by deoxygenated blood. Inverted responses are shown to cluster in these regions and correcting these responses improves maps of hV4 in some hemispheres, including restoring a complete hemifield map in one. A leftwards bias was found whereby 6/10 left hemisphere hV4 maps were incomplete, while this was the case in only 1/10 right hemisphere maps. Incomplete hV4 maps did not correspond with venous artefact in every instance, with incomplete maps being present in the absence of a venous eclipse and complete maps coexisting with a proximate venous eclipse. We also show that mean maps of upper surfaces (near the boundary between cortical grey matter and CSF) provide highly detailed maps of veins on the cortical surface. Results suggest that venous eclipses and inverted voxels can explain some incomplete hV4 maps, but cannot explain the remainder nor the leftwards bias in hV4 coverage reported here.
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Kroeker J, Keith J, Carruthers H, Hanna C, Qureshi N, Calic M, Kaye M, Solow M, Coey J, Sulaiman S. Investigating the time‐lapsed effects of rigid cervical collars on the dimensions of the internal jugular vein. Clin Anat 2019; 32:196-200. [DOI: 10.1002/ca.23264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 07/27/2018] [Accepted: 08/07/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Jenna Kroeker
- Keith B. Taylor Global Scholars Program at Northumbria UniversitySt. George's International School of Medicine Newcastle‐upon‐Tyne NE1 8ST UK
| | - Jay Keith
- Keith B. Taylor Global Scholars Program at Northumbria UniversitySt. George's International School of Medicine Newcastle‐upon‐Tyne NE1 8ST UK
| | - Hailey Carruthers
- Keith B. Taylor Global Scholars Program at Northumbria UniversitySt. George's International School of Medicine Newcastle‐upon‐Tyne NE1 8ST UK
| | - Cherry Hanna
- Keith B. Taylor Global Scholars Program at Northumbria UniversitySt. George's International School of Medicine Newcastle‐upon‐Tyne NE1 8ST UK
| | - Natasha Qureshi
- Keith B. Taylor Global Scholars Program at Northumbria UniversitySt. George's International School of Medicine Newcastle‐upon‐Tyne NE1 8ST UK
| | - Masa Calic
- Keith B. Taylor Global Scholars Program at Northumbria UniversitySt. George's International School of Medicine Newcastle‐upon‐Tyne NE1 8ST UK
| | - Meagan Kaye
- Keith B. Taylor Global Scholars Program at Northumbria UniversitySt. George's International School of Medicine Newcastle‐upon‐Tyne NE1 8ST UK
| | - Marissa Solow
- Keith B. Taylor Global Scholars Program at Northumbria UniversitySt. George's International School of Medicine Newcastle‐upon‐Tyne NE1 8ST UK
| | - James Coey
- Keith B. Taylor Global Scholars Program at Northumbria UniversitySt. George's International School of Medicine Newcastle‐upon‐Tyne NE1 8ST UK
- Department of AnatomySt. George's University Grenada West Indies
| | - Sara Sulaiman
- Department of Applied SciencesNorthumbria University Newcastle‐upon‐Tyne NE1 8ST UK
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Arsava EY, Arsava EM, Oguz KK, Topcuoglu MA. Occipital petalia as a predictive imaging sign for transverse sinus dominance. Neurol Res 2019; 41:306-311. [PMID: 30601110 DOI: 10.1080/01616412.2018.1560643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Occipital petalia is an anatomic description where one of the occipital lobes protrudes towards the contralateral side. Transverse sinus (TS) asymmetry might cause diagnostic challenges with regards to thrombotic or compressive pathologies involving these sinuses. In this study, we investigated the association between occipital petalia and TS hypoplasia on MRI studies. METHODS In 264 subjects with no neurological complaints, occipital bending was determined on T1-weighted images based on the angulation of interhemispheric fissure between occipital lobes with respect to an imaginary midline. TS asymmetry was evaluated visually. Information on handedness and ocular dominance was also gathered from all participants. RESULTS Rightwards bending was observed in 72 subjects (27%), whereas leftwards bending was present in only 10 participants (4%). The presence or direction of bending was related neither to hand nor ocular dominance. In participants with rightwards bending, 72% had a larger TS on the right-side, while only a single subject had a left-sided predilection for venous drainage. In subjects with leftwards bending, 70% had a left-dominant TS drainage system and none had a larger TS on the right. Overall, the direction of bending was predictive of TS dominance on the ipsilateral side with a PPV of 72% (95%CI, 60-82%) for right and 70% (95%CI, 35-92%) for left. DISCUSSION The direction of bending, a relatively straightforward radiologic diagnosis, is closely linked to the side of TS hypoplasia, and thereby might provide physicians with an additional diagnostic clue regarding the interpretation of imaging findings related to TSs and their pathologies.
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Affiliation(s)
- Ezgi Yetim Arsava
- a Department of Neurology, Faculty of Medicine , Hacettepe University , Ankara , Turkey
| | - Ethem Murat Arsava
- a Department of Neurology, Faculty of Medicine , Hacettepe University , Ankara , Turkey
| | - Kader Karlı Oguz
- b Department of Radiology, Faculty of Medicine , Hacettepe University , Ankara , Turkey
| | - Mehmet Akif Topcuoglu
- a Department of Neurology, Faculty of Medicine , Hacettepe University , Ankara , Turkey
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Mumtaz S, Singh M. Surgical review of the anatomical variations of the internal jugular vein: an update for head and neck surgeons. Ann R Coll Surg Engl 2018; 101:2-6. [PMID: 30322289 DOI: 10.1308/rcsann.2018.0185] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The internal jugular vein is one of the major vessels of the neck. The anatomy of this vessel is considered to be relatively stable. It is an important landmark for head and neck surgeons as well as the anaesthetists for both diagnostic and therapeutic purposes. METHODS We present two case reports of the posterior tributary of the internal jugular vein and review the surgical literature regarding anatomical variations of the vein. FINDINGS A total of 1197 patients from 27 published papers were included in this review. Of these patients, 99.6% had neck surgery and the rest were cadaveric dissections. Anatomical variations of the internal jugular vein were found in 2% of the patient cohort (n = 40). The majority of these patients had either bifurcation or fenestration of the vein. The posterior tributary of the internal jugular vein is unusual and is scarcely reported in the literature (three cases). Knowledge of variations in the anatomy of the internal jugular vein assists surgeons in avoiding complications during neck surgery and preventing morbidity. Two rare cases of posterior branching of the internal jugular vein and experience of other surgeons are demonstrated in this extensive review.
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Affiliation(s)
- S Mumtaz
- Oral and Maxillofacial Surgery Department, Mid Essex Hospital Trust , Chelmsford , UK
| | - M Singh
- Oral and Maxillofacial Surgery Department, Mid Essex Hospital Trust , Chelmsford , UK
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A Severe Case of Aneurysmal Malformation of the Vein of Galen, Cardiac Failure and Intrauterine Fetal Death. CURRENT HEALTH SCIENCES JOURNAL 2018; 44:76-79. [PMID: 30622760 PMCID: PMC6295180 DOI: 10.12865/chsj.44.01.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 03/29/2018] [Indexed: 12/05/2022]
Abstract
Aneurism of the vein of Galen is a rare congenital anomaly, where complex arteriovenous malformation are identified between multiple choroidal arteries and the median prosencephalic vein of Markowski, which is a precursor of the vein of Galen, with subsequent aneurysmal enlargement of the respective arteriovenous system. The congenital malformation develops during week 6 to 11 of fetal development. Infants often die from high-output congestive heart failure. We present a case of a 40 years old patient, presented the first time at hospital at
28 weeks of gestation for lower perception of fetal movements. The patient was referred to our Prenatal Diagnosis Unit for a suspected cardiac malformation. We diagnosed cardiomegaly along vein of Galen aneurysmal malformation (VGAM) with severe cardiac failure, ascites, and critical fetal distress. Fetal demise was noted 24 hours later, during the corticosteroid procedures for fetal maturation. A stillborn weighting 2000g with a severe hydropic aspect was born after labor induction. Autopsy was performed following injection of colored gelatin in carotid vessels. The aneurysmal defect was evident in the vein of Galen and straight sinus. We also found the transverse, sagittal and the occipital sinus seriously dilated. We could not highlight the communication with the middle cerebral artery, because of the degradation of the cerebral tissue, despite an optimal preparation
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16
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Chao AC, Han K, Chang FC, Hsu HY, Chung CP, Sheng WY, Chan L, Wu J, Hu HH. Ultrasound diagnosis of transverse sinus hypoplasia using flow profiles of the internal jugular vein. PLoS One 2017; 12:e0181119. [PMID: 28704516 PMCID: PMC5509311 DOI: 10.1371/journal.pone.0181119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 06/25/2017] [Indexed: 11/19/2022] Open
Abstract
Accurate diagnosis of subtypes of transverse sinus (TS) hypoplasia requires more expensive methods like magnetic resonance (MR) imaging. We hypothesized ultrasound findings of the internal jugular vein (IJV) can be surrogate indicators for diagnosis of TS hypoplasia. MR images were reviewed in 131 subjects to evaluate TS diameter and the location and degree of venous flow stenosis and obstruction. Ultrasound parameters including the cross-sectional lumen area (CSA), time-average-mean velocity (TAMV), and flow volume (FV) at each IJV segment were also evaluated. Sixty-nine subjects had TS hypoplasia based on MRV criteria, of which 39 TS hypoplasia were considered a subtype of TS hypoplasia, which is secondary to the downstream venous compression/stenosis or left brachiocephalic vein. In the ultrasound study, the CSA of the IJV ipsilateral to TS hypoplasia was significantly smaller. Further, a contralateral/ipsilateral IJV CSA ratio >1.55 provided good sensitivity, specificity, and positive predictive value for discriminating TS hypoplasia.
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Affiliation(s)
- A-Ching Chao
- Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ke Han
- Department of Neurology and Neuroscience Center, First Hospital of Jilin University, Changchun, Jilin, China
- * E-mail: (HHH); (KH)
| | - Feng-Chi Chang
- Department of Radiology, Taipei Veterans General Hospital and National Yang Ming University, Taipei, Taiwan
| | - Hung-Yi Hsu
- Department of Neurology, Tungs’ Taichung Metro Harbor Hospital, Taichung, Taiwan
| | - Chih-Ping Chung
- Department of Neurology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - Wen-Yung Sheng
- Department of Neurology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - Lung Chan
- Department of Neurology, Taipei Medical University-Shaung Ho Hospital, Taipei, Taiwan
| | - Jiang Wu
- Department of Neurology and Neuroscience Center, First Hospital of Jilin University, Changchun, Jilin, China
| | - Han-Hwa Hu
- Department of Neurology, Taipei Medical University-Shaung Ho Hospital, Taipei, Taiwan
- Cerebrovascular Treatment and Research Center, College of Medicine, Taipei Medical University, Taipei, Taiwan
- * E-mail: (HHH); (KH)
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17
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Sepúlveda I, Schmidt T, Platín E. Intrapetrous Anastomosis between the Internal Jugular Vein and the Superior Petrosal Sinus: Cone Beam Computed Tomography Incidental Finding. J Clin Imaging Sci 2015; 5:46. [PMID: 26430539 PMCID: PMC4584441 DOI: 10.4103/2156-7514.163990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Accepted: 08/13/2015] [Indexed: 11/24/2022] Open
Abstract
This is a case report of a 62-year-old male who presented to the Ear, Nose, and Throat clinic for a follow-up exam for hearing loss stemming from a fall from a horse in his infancy. A Cone Beam Computed Tomography (CBCT) examination revealed an intrapetrous communication between the internal jugular vein bulb and the superior petrosal sinus. Three-dimensional bone and soft tissues volume renderings were generated to demonstrate this incidental anatomical variant.
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Affiliation(s)
- Ilson Sepúlveda
- ENT-Head and Neck Surgery Service, General Hospital of Concepcion, Chile ; Department of Oral and Maxillofacial Radiology, Finis Terrae University School of Dentistry, Santiago, Chile
| | - Thomas Schmidt
- ENT-Head and Neck Surgery Service, General Hospital of Concepcion, Chile ; School of Medicine, University of Concepcion, Concepción, Chile
| | - Enrique Platín
- Department of Oral and Maxillofacial Radiology, University of North Carolina School of Dentistry, Chapel Hill, NC, USA
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18
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Marcotti S, Marchetti L, Cecconi P, Votta E, Fiore GB, Barberio A, Viotti S, Redaelli A, Laganà MM. An anatomy-based lumped parameter model of cerebrospinal venous circulation: can an extracranial anatomical change impact intracranial hemodynamics? BMC Neurol 2015; 15:95. [PMID: 26099795 PMCID: PMC4476203 DOI: 10.1186/s12883-015-0352-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 06/10/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The relationship between extracranial venous system abnormalities and central nervous system disorders has been recently theorized. In this paper we delve into this hypothesis by modeling the venous drainage in brain and spinal column areas and simulating the intracranial flow changes due to extracranial morphological stenoses. METHODS A lumped parameter model of the cerebro-spinal venous drainage was created based on anatomical knowledge and vessels diameters and lengths taken from literature. Each vein was modeled as a hydraulic resistance, calculated through Poiseuille's law. The inputs of the model were arterial flow rates of the intracranial, vertebral and lumbar districts. The effects of the obstruction of the main venous outflows were simulated. A database comprising 112 Multiple Sclerosis patients (Male/Female = 42/70; median age ± standard deviation = 43.7 ± 10.5 years) was retrospectively analyzed. RESULTS The flow rate of the main veins estimated with the model was similar to the measures of 21 healthy controls (Male/Female = 10/11; mean age ± standard deviation = 31 ± 11 years), obtained with a 1.5 T Magnetic Resonance scanner. The intracranial reflux topography predicted with the model in cases of internal jugular vein diameter reduction was similar to those observed in the patients with internal jugular vein obstacles. CONCLUSIONS The proposed model can predict physiological and pathological behaviors with good fidelity. Despite the simplifications introduced in cerebrospinal venous circulation modeling, the key anatomical feature of the lumped parameter model allowed for a detailed analysis of the consequences of extracranial venous impairments on intracranial pressure and hemodynamics.
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Affiliation(s)
- Stefania Marcotti
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo Da Vinci, 32, 20133, Milan, Italy.
| | - Lara Marchetti
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo Da Vinci, 32, 20133, Milan, Italy.
| | - Pietro Cecconi
- Magnetic Resonance Laboratory, Fondazione Don Carlo Gnocchi ONLUS, IRCCS Santa Maria Nascente, Via Capecelatro 66, 20148, Milan, Italy.
| | - Emiliano Votta
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo Da Vinci, 32, 20133, Milan, Italy.
| | - Gianfranco Beniamino Fiore
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo Da Vinci, 32, 20133, Milan, Italy.
| | - Antonello Barberio
- Magnetic Resonance Laboratory, Fondazione Don Carlo Gnocchi ONLUS, IRCCS Santa Maria Nascente, Via Capecelatro 66, 20148, Milan, Italy.
| | - Stefano Viotti
- Magnetic Resonance Laboratory, Fondazione Don Carlo Gnocchi ONLUS, IRCCS Santa Maria Nascente, Via Capecelatro 66, 20148, Milan, Italy.
| | - Alberto Redaelli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo Da Vinci, 32, 20133, Milan, Italy.
| | - Maria Marcella Laganà
- Magnetic Resonance Laboratory, Fondazione Don Carlo Gnocchi ONLUS, IRCCS Santa Maria Nascente, Via Capecelatro 66, 20148, Milan, Italy.
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Maller JJ, Thomson RHS, Rosenfeld JV, Anderson R, Daskalakis ZJ, Fitzgerald PB. Reply: occipital bending in depression. ACTA ACUST UNITED AC 2014; 138:e318. [PMID: 25027501 DOI: 10.1093/brain/awu199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jerome J Maller
- 1 Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne Victoria, Australia
| | - Richard H S Thomson
- 1 Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne Victoria, Australia
| | - Jeffrey V Rosenfeld
- 2 Division of Clinical Sciences and Department of Surgery, Central Clinical School, Monash University, Professor and Director, Department of Neurosurgery, Alfred Hospital, Melbourne Victoria, Australia
| | - Rodney Anderson
- 1 Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne Victoria, Australia
| | - Zafiris J Daskalakis
- 3 Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Paul B Fitzgerald
- 1 Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne Victoria, Australia
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