title: Active regulation of cerebral venous tone: simultaneous arterial and venous transcranial Doppler sonography during a Valsalva manoeuvre.
abstract: The aim of this study was to analyse the cerebral venous outflow in relation to the arterial inflow during a Valsalva manoeuvre (VM). In 19 healthy volunteers (mean age 24.1 +/- 2.6 years), the middle cerebral artery (MCA) and the straight sinus (SRS) were insonated by transcranial Doppler sonography. Simultaneously the arterial blood pressure was recorded using a photoplethysmographic method. Two VM of 10 s length were performed per participant. Tracings of the variables were then transformed to equidistantly re-sampled data. Phases of the VM were analysed regarding the increase of the flow velocities and the latency to the peak. The typical four phases of the VM were also found in the SRS signal. The relative flow velocity (FV) increase was significantly higher in the SRS than in the MCA for all phases, particularly that of phase IV (p < 0.01). Comparison of the time latency of the VM phases of the MCA and SRS only showed a significant difference for phase I (p < 0.01). In particular, there was no significant difference for phase IV (15.8 +/- 0.29 vs. 16.0 +/- 0.28 s). Alterations in venous outflow in phase I are best explained by a cross-sectional change of the lumen of the SRS, while phases II and III are compatible with a Starling resistor. However, the significantly lager venous than the arterial overshoot in phase IV may be explained by the active regulation of the venous tone.
authors.affiliation: Department of Neurology, Justus-Liebig University, Am Steg 14, 35385 Giessen, Germany. erwin.stolz@neuro.med.uni-giessen.de
authors.forename: Erwin
authors.initials: E
authors.lastname: Stolz
authors.forename: Damian A W
authors.initials: DA
authors.lastname: Rüsges
authors.forename: Oskar
authors.initials: O
authors.lastname: Hoffmann
authors.forename: Tibo
authors.initials: T
authors.lastname: Gerriets
authors.forename: Max
authors.initials: M
authors.lastname: Nedelmann
authors.forename: Piergiogio
authors.initials: P
authors.lastname: Lochner
authors.forename: Manfred
authors.initials: M
authors.lastname: Kaps
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D001794:Blood Pressure; D002550:Cerebral Veins / Q000000981:diagnostic imaging* / Q000502:physiology; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D008297:Male; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging* / Q000502:physiology; D017156:Photoplethysmography; D011930:Reaction Time; D013997:Time Factors; D017585:Ultrasonography, Doppler, Transcranial; D014636:Valsalva Maneuver; D055815:Young Adult