Massive jugular and dural sinus reflux associated with cerebral death.
Radionuclide cerebral angiograms demonstrated massive jugular venous reflux in two children with clinical and electroencephalographic evidence of cerebral death. With an antecubital injection, the tracer flowed up the jugular vein, through the transverse dural sinus, and down the contralateral jugular vein. No arterial flow was seen. We hypothesize that this unusual pattern reflects the absence of normal antegrade flow through the venous system. The appearance of jugular reflux is distinct from arterial flow and should not be confused with it. These cases illustrate communication between the systemic venous system and the dural sinuses. Although this pattern in not diagnostic of cerebral death, the appearance of radiotracer in the dural sinuses does not establish the presence of cerebral perfusion.
Shore
R M
RM
Department of Radiology, University of Wisconsin, Madison.
Rao
B K
BK
Berg
O B
OB
D001926:Brain Death; D002560:Cerebrovascular Circulation; D002648:Child; D003392:Cranial Sinuses / Q000000981:diagnostic imaging*; D004388:Dura Mater / Q000098:blood supply*; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging*; D008297:Male; D009942:Organometallic Compounds; D015609:Organotechnetium Compounds; D004369:Pentetic Acid; D011877:Radionuclide Imaging; D013400:Sugar Acids; D013667:Technetium; D016284:Technetium Tc 99m Pentetate
D009942:Organometallic Compounds; D015609:Organotechnetium Compounds; D013400:Sugar Acids; D013667:Technetium; D004369:Pentetic Acid; C100014:technetium Tc 99m gluceptate; D016284:Technetium Tc 99m Pentetate