Related Experiment Video
Updated: Jul 4, 2026
09:32
Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge
Published on: January 20, 2023
Retrograde jugular flow associated with idiopathic normal pressure hydrocephalus
Nagato Kuriyama1, Takahiko Tokuda, Junichi Miyamoto
1Department of Neurology and Gerontology, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan.
Annals of Neurology
|June 24, 2008
Summary
Retrograde jugular venous flow is significantly more common in patients with idiopathic normal pressure hydrocephalus (iNPH). This finding suggests analyzing jugular venous flow may aid in iNPH diagnosis.
Area of Science:
- Neurology
- Vascular Physiology
Background:
- Idiopathic normal pressure hydrocephalus (iNPH) is a neurological condition characterized by impaired cerebrospinal fluid (CSF) drainage.
- The exact mechanisms underlying iNPH development remain incompletely understood.
- Understanding CSF drainage pathways is crucial for diagnosing and managing iNPH.
Purpose of the Study:
- To investigate the relationship between cerebrospinal fluid (CSF) drainage pathways and the development of idiopathic normal pressure hydrocephalus (iNPH).
- To assess internal jugular vein (IJV) flow patterns during the Valsalva maneuver in iNPH patients and controls.
Main Methods:
- Air-contrast ultrasound venography was employed to examine IJV flow patterns.
- The study included 20 patients diagnosed with iNPH and 13 healthy control subjects.
- The Valsalva maneuver was performed to elicit and observe venous flow changes.
Main Results:
- A significantly higher frequency of retrograde jugular venous flow was observed in the iNPH group (95%) compared to the control group (23%).
- Statistical analysis (chi-squared test) confirmed a significant difference between the groups (p < 0.001).
Conclusions:
- Retrograde jugular venous flow appears to be associated with the development of idiopathic normal pressure hydrocephalus.
- Analyzing retrograde jugular venous flow may serve as a valuable diagnostic tool for iNPH.
Related Concept Videos
01:19Veins of Head and Neck
The blood drainage from the head and neck is primarily managed by three pairs of veins: the external jugular, internal jugular, and vertebral veins. The external jugular veins drain superficial scalp and face structures, passing over the sternocleidomastoid muscles to empty into the subclavian veins.
On the other hand, the vertebral veins, unlike their arterial counterparts, are not primarily responsible for brain drainage. Instead, they drain the cervical vertebrae, spinal cord, and some small...
On the other hand, the vertebral veins, unlike their arterial counterparts, are not primarily responsible for brain drainage. Instead, they drain the cervical vertebrae, spinal cord, and some small...
01:14Increased Intracranial Pressure l: Introduction
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
01:29Increased Intracranial Pressure ll: Pathophysiology
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
01:19Urodynamic Studies: Uroflowmetry
Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...