Enhanced global mathematical model for studying cerebral venous blood flow

Here we extend the global, closed-loop, mathematical model for the cardiovascular system in Müller and Toro (2014) to account for fundamental mechanisms affecting cerebral venous haemodynamics: the interaction between intracranial pressure and cerebral vasculature and the Starling-resistor like behaviour of intracranial veins. Computational results are compared with flow measurements obtained from Magnetic Resonance Imaging (MRI), showing overall satisfactory agreement. The role played by each model component in shaping cerebral venous flow waveforms is investigated. Our results are discussed in light of current physiological concepts and model-driven considerations, indicating that the Starling-resistor like behaviour of intracranial veins at the point where they join dural sinuses is the leading mechanism. Moreover, we present preliminary results on the impact of neck vein strictures on cerebral venous hemodynamics. These results show that such anomalies cause a pressure increment in intracranial cerebral veins, even if the shielding effect of the Starling-resistor like behaviour of cerebral veins is taken into account.     

A morphological study of the vertebral venous plexus and its connections in the Cape dune mole‐rat,Bathyergus suillus (Bathyergidae)

Bathyergus suillus are subterranean rodents found in the Western Cape of South Africa, where they inhabit sandy, humid burrows. Vertebral venous plexuses around the vertebral column have been implicated in aiding the maintenance of a constant central nervous system temperature via its connections with muscles and interscapular brown adipose tissue. The morphology of the vertebral venous plexuses and its connections in B.suillus were investigated. Frozen (n = 10) animals were defrosted; the venous system injected with latex and the vertebral venous plexuses, azygos‐ and intercostal veins dissected along the dorsal and ventral aspects of the vertebral column. Specimens (n = 4) were used for histological serial cross sections of the thoracic vertebrae. Veins drained from the interscapular brown adipose tissue to the external vertebral venous plexus, via a dorsal vein at the spinous process of T2 which might represent the “vein of Sulzer” described in rats. The intercostal veins cranial to the level of T8 drained directly into the ventral external vertebral venous plexus instead of into the azygos vein as seen in rats. The azygos vein was situated ventrally on the thoracic vertebral bodies in the median plane as opposed to most rodents that have a left sided azygos vein. The internal vertebral venous plexus consisted of two ventrolateraly placed longitudinal veins in the spinal epidural space. Veins from the forelimbs entered the internal vertebral venous plexus directly at the levels of C7 and T1 and have not been described in other rodents. Serial histological sections, revealed no regulatory valves in vessels leading toward the internal vertebral venous plexus, allowing blood to presumably move in both directions within the vertebral venous plexus. The vertebral venous plexus of B. suillus shows similarities to that of the rat but the vessels from the forelimbs draining directly into to the internal vertebral venous plexus and the position of the azygos vein and the intercostal veins draining into the external vertebral venous plexus are notable exceptions. J. Morphol., 2011. © 2010 Wiley‐Liss, Inc.     

The venous system of the head and neck of the opossum (Didelphis virginiana)

The venous system of the head and neck of the opossum, Didelphis virginiana, was studied by injecting the veins with a tinctorial mass. Gross dissection spechmens injected with a colored gelatin solution and corrosion specimens prepared by Batson's technique (Batson, '55) were utilized to describe the venous pattern in greater detail than is presently available in the literature. The venous drainage of the superficial structures of the head is principally by way of the V. jugularis externa and its tributaries. Although small emissary veins connect the Sinus cavernosus with the Plexus pterygoideus and the V. maxillaris, the dural venous sinuses drain primarily into the Plexus vertebralis internus and into the V. maxillaris by way of the V. emissaria foraminis retroarticularis. The small V. jugularis interna receives minor connections from the Plexus pterygoideus, the Sinus cavernosus and the Sinus petrosus ventralis as well as anastomotic tributaries from the Plexus vertebralis and the plexus of veins around the hyoid bone. However, the V. jugularis interna serves mainly as a pathway for venous drainage from the deeper structures of the neck and only minimally for draining the brain.     

Alternative venous outflow vessels in microvascular breast reconstruction

The lack of adequate recipient vessels often complicates microvascular breast reconstruction in patients who have previously undergone mastectomy and irradiation. In addition, significant size mismatch, particularly in the outflow veins, is an important contributor to vessel thrombosis and flap failure. The purpose of this study was to review the authors' experience with alternative venous outflow vessels for microvascular breast reconstruction. In a retrospective analysis of 1278 microvascular breast reconstructions performed over a 10-year period, the authors identified all patients in whom the external jugular or cephalic veins were used as the outflow vessels. Patient demographics, flap choice, the reasons for the use of alternative venous drainage vessels, and the incidence of microsurgical complications were analyzed. The external jugular was used in 23 flaps performed in procedures with 22 patients. The superior gluteal and transverse rectus abdominis musculocutaneous (TRAM) flaps were used in the majority of the cases in which the external jugular vein was used (72 percent gluteal, 20 percent TRAM flap). The need for alternative venous outflow vessels was usually due to a significant vessel size mismatch between the superior gluteal and internal mammary veins (74 percent). For three of the external jugular vein flaps (13 percent), the vein was used for salvage after the primary draining vein thrombosed, and two of three flaps in these cases were eventually salvaged. In three patients, the external jugular vein thrombosed, resulting in two flap losses, while the third was salvaged using the cephalic vein. A total of two flaps were lost in the external jugular vein group. The cephalic vein was used in 11 flaps (TRAM, 64.3 percent; superior gluteal, 35.7 percent) performed in 11 patients. In five patients (54.5 percent), the cephalic vein was used to salvage a flap after the primary draining vein thrombosed; the procedure was successful in four cases. In three patients, the cephalic vein thrombosed, resulting in two flap losses. One patient suffered a thrombosis after the cephalic vein was used to salvage a flap in which the external jugular vein was initially used, leading to flap loss, while a second patient experienced cephalic vein thrombosis on postoperative day 7 while carrying a heavy package. There was only one minor complication attributable to the harvest of the external jugular or cephalic vein (small neck hematoma that was aspirated), and the resultant scars were excellent. The external jugular and cephalic veins are important ancillary veins available for microvascular breast reconstruction. The dissection of these vessels is straightforward, and their use is well tolerated and highly successful.     

The study of cerebral venous blood flow disturbance peculiarity in the norm and under the extravasal compression of brachiocephalic veins with the use of magnetic resonance venography and ultrasound duplex scanning

The MR-venography of the veins and brain venous sinuses, brachiocephalic veins an internal jugular veins duplex scanning have been performed in order to study the distinctions of cerebral venous hemodynamics of healthy people and the patients with venous encephalopathy caused by the extravasal compression of the brachiocephalic veins at the neck level and the superior sections of mediastinum. It has been revealed that the blood flow reducing in transverse brain sinuses occurs not only in the case of outflow disorder in the distal sections of the venous system, but also in norm. This reducing depends on anatomic constitution of confluens sinuum and the venous angle type of brachiocephalic veins. The three venous angle types of brachiocephalic veins have been distinguished: y-type, mu-type and Y-type. It has been registered that in case of the mu-type angle the blood flow can be reduced in norm due to peripheral resistance increase at the physiological bends of nearly a right angle type. The distinctions of hemodynamics in case of venous obstruction in contrast to arterial obstruction have been described. It has been registered that in case of outflow trouble in one of the internal jugular veins the speed and the volume of the blood flow in it are progressively reduced depending on the duration and the manifestation of compression. All this results in narrowing of the vein diameter from the affected side, and in compensatory distention of the diameter and increase of blood flow volume in the contralateral internal jugular vein, vertebral and external jugular veins, in succession.     

The intrarenal and pericapsular venous systems of kidneys of the ringed seal, Phoca hispida

The kidneys of Phoca hispida are comprised of many closely adherent renculi, each of which is a small kidney, functionally independent of its neighbours except with respect to venous drainage. Venous blood from the rencular parenchyma drains to the periphery through interlobular veins. These interlobular veins empty into a perirencular plexus comprised of subcapsular veins on the free surface of the renculus, interrencular veins on adjoined surfaces, and marginal subcapsular veins lying in the furrows between adjoined renculi. A pericapsular plexus of large veins overlies the marginal subcapsular veins and has frequent connections with them. Blood drains from the pericapsular plexus into large superficial collecting veins that converge over the surface of the kidney toward the divided hilum and connect directly to the paired trunks of the posterior vena cava. There are also connections to other major venous systems of the region. There is no arcuate venous system, no major vein at the rencular hilum, and no vein of consequence emerging from the renal hilum. Venous outflow is virtually entirely directed to the peripheral plexuses. The venous pattern differs from that of most mammals in which blood drains from the renal parenchyma to arcuate veins and leaves the kidney through a renal vein, or veins, emerging from the hilum. The walls of veins in the kidney are remarkably thin in comparison to their size. Subcapsular veins up to 0.5 mm wide have walls on the parenchymal side that in places consist only of a thin, fenestrated endothelium and a basal lamina.     

Progesterone in uterine and arterial tissue and in jugular and uterine venous plasma of sheep

Concentrations of progesterone in uterine and arterial tissue and in uterine and jugular venous plasma were determined. Blood was collected on Days 4 and 9 postestrus from the jugular vein and the first and last venous branches draining each uterine cornu; uterine tissue and arteries were subsequently collected. Progesterone was greater (p less than 0.05) in the cranial third than in the middle or caudal thirds of the uterine horn adjacent to the corpus luteum (CL)-bearing ovary or in any third of the contralateral horn. Progesterone in uterine arterial segments adjacent to the CL-bearing ovary was higher (p less than 0.05) than in contralateral segments. Progesterone was higher (p less than 0.05) in blood from the first venous branch of the cranial third of the uterine cornu adjacent to the ovary with the CL, than in the last branch of the caudal third, or contralateral horn, or in jugular blood. When oviductal veins were resected on Day 9 postestrus, progesterone in the first vein draining the cranial third of the uterine cornu adjacent to the CL-containing ovary was not different (p greater than 0.05) 48 h after resection than in the same vessel in the opposite horn or in jugular blood. We concluded that progesterone and other ovarian products may be delivered to the uterus locally.     

Arteriovenous malformation of the stomach

A patient with chronic anemia is presented who radiologically showed prominent rugae of the stomach. Angiography demonstrated an arteriovenous malformation with a large feeding artery and prominent draining veins.     

Blood supply of the trachea and bronchi in the rat

Existence of longitudinal and circular arterio-arterial anastomoses are stated, as well as various ways of outflow from the veins of the organs studied; this demonstrates essential compensatory abilities of this bed in blood supply regulation and draining at inflow and outflow from the microcirculatory system bed. Different topography of the arterial sources, venous plexuses, capillary fields allows to suppose different histophysiology of the tracheal zones mentioned: the anterior (laryngotracheal), middle and posterior (bifurcational). For the tracheal microcirculatory bed, metamerically repeated microcirculatory areas are peculiar. Distribution of the bronchial arteries takes place up to the terminal bronchi. In the area of the latter, anastomoses of the bronchial vessels with the pulmonary artery are observed.     

The Use of Dynamic Tracer Concentration in Veins for Quantitative DCE-MRI Kinetic Analysis in Head and Neck

Background

Head and neck Magnetic Resonance (MR) Images are vulnerable to the arterial blood in-flow effect. To compensate for this effect and enhance accuracy and reproducibility, dynamic tracer concentration in veins was proposed and investigated for quantitative dynamic contrast-enhanced (DCE) MRI analysis in head and neck.

Methodology

21 patients with head and neck tumors underwent DCE-MRI at 3T. An automated method was developed for blood vessel selection and separation. Dynamic concentration-time-curves (CTCs) in arteries and veins were used for the Tofts model parameter estimations. The estimation differences by using CTCs in arteries and veins were compared. Artery and vein voxels were accurately separated by the automated method. Remarkable inter-slice tracer concentration differences were found in arteries while the inter-slice concentration differences in veins were moderate. Tofts model fitting by using the CTCs in arteries and veins produced significantly different parameter estimations. The individual artery CTCs resulted in large (>50% generally) inter-slice parameter estimation variations. Better inter-slice consistency was achieved by using the vein CTCs.

Conclusions

The use of vein CTCs helps to compensate for arterial in-flow effect and reduce kinetic parameter estimation error and inconsistency for head and neck DCE-MRI.     

Arterial Shear Stress Reduces Eph-B4 Expression in Adult Human Veins

Vein graft adaptation to the arterial environment is characterized by loss of venous identity, with reduced Ephrin type-B receptor 4 (Eph-B4) expression but without increased Ephrin-B2 expression. We examined changes of vessel identity of human saphenous veins in a flow circuit in which shear stress could be precisely controlled. Medium circulated at arterial or venous magnitudes of laminar shear stress for 24 hours; histologic, protein, and RNA analyses of vein segments were performed. Vein endothelium remained viable and functional, with platelet endothelial cell adhesion molecule (PECAM)-expressing cells on the luminal surface. Venous Eph-B4 expression diminished (p = .002), Ephrin-B2 expression was not induced (p = .268), and expression of osteopontin (p = .002) was increased with exposure to arterial magnitudes of shear stress. Similar changes were not found in veins placed under venous flow or static conditions. These data show that human saphenous veins remain viable during ex vivo application of shear stress in a bioreactor, without loss of the venous endothelium. Arterial magnitudes of shear stress cause loss of venous identity without gain of arterial identity in human veins perfused ex vivo. Shear stress alone, without immunologic or hormonal influence, is capable of inducing changes in vessel identity and, specifically, loss of venous identity.     

Extrajugular pathways of human cerebral venous blood drainage assessed by duplex ultrasound.

Cerebral venous drainage in humans is thought to be ensured mainly via the internal jugular veins (IJVs). However, anatomic, angiographic, and ultrasound studies suggest that the vertebral venous system serves as an important alternative drainage route. We assessed venous blood volume flow in vertebral veins (VVs) and IJVs of 12 healthy volunteers using duplex ultrasound. Measurements were performed at rest and during a transient bilateral IJV and a circular neck compression. Total venous blood volume flow at rest was 766 +/- 226 ml/min (IJVs: 720 +/- 232, VVs: 47 +/- 33 ml/min). During bilateral IJV compression, VV flow increased to 128 +/- 64 ml/min. Circular neck compression, causing an additional deep cervical vein obstruction, led to a further rise in VV volume flow (186 +/- 70 ml/min). As the observed flow increase did not compensate for IJV flow cessation, other parts of the vertebral venous system, like the intraspinal epidural veins and the deep cervical veins, have to be considered as additional alternative drainage pathways.     

Venous stagnation induced by 7 dyas in HDT, in the cerebral, ophtalmic, renal and splancnhic territories

The scientific objectives was to quantify the vascular changes in the brain, eye fundus, renal parenchyma, and splanchnic network. Heart, Portal, Jugular, femoral veins were investigate by Echography. The cerebral mesenteric, renal and ophthalmic arteries were investigated by Doppler. Eye fundus vein an papilla were investigated by optical video eye fundus. The Left ventricle volume decreased as usual in HDT. The cerebral and ophthalmic vascular resistances did'nt change whereas the eye fundus papilla and vein, and the Jugular vein increased. These arterial and venous data confirm the existence of cephalic venous blood stasis without sign of intracranial hypertension. On the other hand the kidney volume increased which is in agreement with blood flow stagnation at this level. At last the Mesenteric vascular resistance decreased and the Portal vein section increased in HDT which is in favor of an increase in flow and flow volume through the splanchnic area.     

Urogenital vasculature and local steroid concentrations in the uterine branch of the ovarian vein of the female tammar wallaby (Macropus eugenii)

The urogenital vasculature of the tammar comprises 4 major paired arteries and veins: the ovarian, the cranial urogenital, the caudal urogenital and the internal pudendal artery and vein. The ovarian artery and vein and their uterine branches which supply the ovary, oviduct and uterus, ramify extensively. Each anterior urogenital artery and vein supplies the caudal regions of the ipsilateral uterus, lateral and median vagina and cranial parts of the urogenital sinus. The caudal urogenital arteries and veins supply the urogenital sinus and caudal regions of the bladder. The internal pudendal artery and vein vascularize the cloacal region, with some anastomoses with branches of the external pudendal vessels. Anastomoses connect the uterine branch of the ovarian artery with the uterine branch of the cranial urogenital and cranial branches of the caudal urogenital arteries, and connect the caudal urogenital and the internal pudendal arteries. Anastomotic connections between the left and right arterial supply also occur across the midline of the cervical regions of the uteri and the anterior lateral vaginae. Similar connections are seen in the venous system. The uterine branch of the ovarian artery ramifies extensively very close to the ovary, giving a plexiform arrangement with the ovarian veins, and also with the uterine venous system on the lateral side of each uterus. This plexiform structure provides an anatomical arrangement which could allow a local transfer of ovarian hormones from ovarian vein into the uterine arterial supply, and thence to the ipsilateral uterus. Progesterone concentrations in plasma from the mesometrial side of the uterine branch of the ovarian vein are markedly higher than in tail vein plasma, especially during the 'Day 5 peak' early in pregnancy, and also at full term. There is also a marked decrease in progesterone concentration from all sites immediately before birth as previously reported for peripheral plasma. These results support the suggestion of a countercurrent transfer mechanism, at least for progesterone, and possibly other hormones, between the ovarian vein and uterine artery. Such a local transfer could explain the different morphological responses of the endometria of the two adjacent uteri during pregnancy in macropodid marsupial species.     

Spontaneous Reperfusion after In Situ Thromboembolic Stroke in Mice

Injection of thrombin into the middle cerebral artery (MCA) of mice has been proposed as a new model of thromboembolic stroke. The present study used sequential multiparametric Magnetic Resonance Imaging (MRI), including Magnetic Resonance Angiography (MRA), Diffusion-Weighted Imaging (DWI) and Perfusion-Weighted Imaging (PWI), to document MCA occlusion, PWI-DWI mismatch, and lesion development. In the first experiment, complete MCA occlusion and reproducible hypoperfusion were obtained in 85% of animals during the first hour after stroke onset. In the second experiment, 80% of animals showed partial to complete reperfusion during a three-hour follow-up. Spontaneous reperfusion thus contributed to the variability in ischemic volume in this model. The study confirmed the value of the model for evaluating new thrombolytic treatments, but calls for extended MRI follow-up at the acute stage in therapeutic studies.     

Veins of the human cerebellum

(1) The veins of the human cerebellum, which may be classified into internal and external venous channels, correspond, in this respect, to the veins of the cerebral hemispheres. (2) The external cerebellar veins are arranged in three groups which, in turn, correspond to the three cerebellar surfaces and which communicate extensively. Accordingly, the terminal segments of the cerebellar veins overlap, which implies that no one-to-one relationship exists between the mouths of the individual veins and their respective distributions. (3) The terminal segments of the cerebellar veins are the superior petrosal sinus, the tentorial venous sinuses, the great vein of Galen and the internal vertebral plexus. (4) The tentorial venous channels may form a collateral venous arrangement. (5) The internal cerebellar veins consist of the nuclear veins and the medullary veins. (6) The medullary veins form a cortex-perforating group and a group located in the basal medullary region. The latter form a venous arborization of blood vessels not described thus far. This group of veins opens chiefly into the vein of the lateral recess of the fourth ventricle.(7) Attention is called to a 'venous watershed' corresponding to the one that exists in the cerebral hemispheres. (8) The veins of the dentate nucleus are composed of several venous channels draining its external surface and one single vein draining its internal surface. The latter has not been described thus far. The external veins of the dentate nucleus open into the venous star and the cortex-perforating veins. The internal nuclear vein, on the other hand, emerging from the hilum of the dentate nucleus, runs along the superior cerebellar peduncle. Thus, the term 'vena centralis nuclei dentati' appears to be appropriate to designate this vessel. It ultimately opens into the precentral cerebellar vein. (9) In certain places, various-colored substances used for injection form mixed pools.     

Status of the circulatory bed of the vascular membrane of the eyeball and retrobulbar structures during experimental venous stasis

In 43 test animals the state of the blood bed in the retrobulbar formations and the eyeball vasular tunic has been studied under venous congestion produced by ligation of the anterior vena cava (in dogs) and both external jugular veins (in rabbits). A complex of histological, histotopographic, morphometric and variation-statistical techniques has been used. The results obtained demonstrate that disturbances in the venous outflow in the anterior vena cava system produce certain responses in all parts of the retrotubular adipose tissue, of the eyeball muscles, of the optic nerve tunics, of the vascular tunic. Certain stageness is noted in the course of venous congestion. Places of the greatest morphological changes in the eyeball vascular tunic are determined. They are zones of vorticose veins formation and the area corresponding to the posterior pole of the eyeball. The analysis of the specific areas of the intermuscular arteries and veins cross sections demonstrates that in the reaction of these vessels to the different venous outflow in the anterior vena cava system these is certain unevenness in different ofthalmic muscles.     

Blood supply of the human cervical sympathetic chain and ganglia

OBJECTIVE: Cadaveric studies of the blood supply to the human cervical sympathetic chain and ganglia are lacking in the English literature. This study seeks to elucidate the gross blood supply of the cervical sympathetic chain so as to avoid surgical disruption of these vessels and thus decrease the risk of vascular insufficieny and subsequent dysfunction of thoracolumbar autonomic outflow to the head and neck. METHODS: Twelve (24 sides) human cadavers (8 male and 4 female) were dissected and their brachiocephalic veins, internal carotid arteries, and vertebral arteries cannulated. Red and blue latex was injected into the arteries and veins respectively. Dissection of the neck was carefully performed and the blood supply of the cervical sympathetic chain identified. RESULTS: The primary arterial supply to the sympathetic chain and ganglia were from superior to inferior the ascending pharyngeal, ascending cervical, thyrocervical trunk, and supreme intercostal arteries. The primary venous drainage of these structures was primarily by direct posterior branches into the internal jugular vein. In addition, we have found an area at the junction of the lower two-thirds and upper one-third of the neck, which is deficient in blood supply (both arterial and venous). CONCLUSIONS: Although sympathetic injury is a rare consequence of cervical operations, the current data should be useful to the surgeon who operates in the cervical region so as to avoid potential complications from disruption of the primary blood supply of the cervical sympathetic chain and ganglia. Also, future techniques of selective iatrogenic disruption of the blood supply to portions of these structures e.g. stellate ganglion may be helpful in treating entities such as hyperhydrosis.     

The cerebrospinal venous system: anatomy, physiology, and clinical implications

There is substantial anatomical and functional continuity between the veins, venous sinuses, and venous plexuses of the brain and the spine. The term "cerebrospinal venous system" (CSVS) is proposed to emphasize this continuity, which is further enhanced by the general lack of venous valves in this network. The first of the two main divisions of this system, the intracranial veins, includes the cortical veins, the dural sinuses, the cavernous sinuses, and the ophthalmic veins. The second main division, the vertebral venous system (VVS), includes the vertebral venous plexuses which course along the entire length of the spine. The intracranial veins richly anastomose with the VVS in the suboccipital region. Caudally, the CSVS freely communicates with the sacral and pelvic veins and the prostatic venous plexus. The CSVS constitutes a unique, large-capacity, valveless venous network in which flow is bidirectional. The CSVS plays important roles in the regulation of intracranial pressure with changes in posture, and in venous outflow from the brain. In addition, the CSVS provides a direct vascular route for the spread of tumor, infection, or emboli among its different components in either direction.     

Comparative bone anatomy of commonly used laboratory animals: implications for drug discovery

To accommodate functional demands, the composition and organization of the skeleton differ among species. Microcomputed tomography has improved our ability markedly to assess structural parameters of cortical and cancellous bone. The current study describes differences in cortical and cancellous bone structure, bone mineral density, and morphology (geometry) at the proximal femur, proximal femoral diaphysis, lumbar vertebrae, and mandible in mice, rats, rabbits, dogs, and nonhuman primates. This work enhances our understanding of bone gross and microanatomy across lab animal species and likely will enable scientists to select the most appropriate species and relevant bone sites for research involving skeleton. We evaluated the gross and microanatomy of the femora head and neck, lumbar spine, and mandible and parameters of cancellous bone, including trabecular number, thickness, plate separation, and connectivity among species. The skeletal characteristics of rabbits, including a very short femoral neck and small amounts of cancellous bone at the femoral neck, vertebral body, and mandible, seem to make this species the least desirable for preclinical research of human bone physiology; in comparison, nonhuman primates seem the most applicable for extrapolation of data to humans. However, rodent (particularly rat) models are extremely useful for conducting basic research involving the skeleton and represent reliable and affordable alternatives to dogs and nonhuman primates. Radiology and microcomputed tomography allow for reliable evaluation of bone morphology, microarchitecture, and bone mineral density in preclinical and clinical environments.