Inga Koerte MD, Presenter: Nothing to Disclose

Andreas Pomschar, Abstract Co-Author: Nothing to Disclose

Max Schick, Abstract Co-Author: Nothing to Disclose

Sang Hoon Lee MS, Abstract Co-Author: Nothing to Disclose

Birgit Betina Ertl-Wagner MD, Abstract Co-Author: Scientific Advisory Board, Koninklijke Philips Electronics NV

Noam Alperin PhD, Abstract Co-Author: Stockholder, Alperin Noninvasive Diagnostics, Inc

Nikolaus Plesnila, Abstract Co-Author: Nothing to Disclose

Andreas Straube MD, Abstract Co-Author: Nothing to Disclose

Florian Heinen, Abstract Co-Author: Nothing to Disclose

Maximilian F. Reiser MD, Abstract Co-Author: Nothing to Disclose

To investigate the distribution of cerebral venous drainage between primary (jugular veins) and secondary (e.g. epidural, vertebral, and deep cervical veins) channels, intracranial compliance (ICC) and intracranial pressure (ICP) in subjects with history of mild traumatic brain injury (MTBI).

Thirty subjects (15 subjects with history of MTBI and 15 age- and gender-matched controls) were investigated using 3T MR. A 2D-time-of-flight MRV of the upper neck was performed to visualize the venous vasculature. Cine-phase contrast sequences were performed to quantify arterial inflow, venous drainage through primary and secondary venous channels and craniospinal CSF flow, to derive an MR estimate of ICC from the ratio of the maximal volume and pressure changes that occur during the cardiac cycle. Intracranial pressure (MR-ICP) is estimated based on the inverse relationship between compliance and pressure.

Subjects with history of MTBI demonstrated a significantly higher mean venous drainage through secondary channels compared to the controls (12.3±10.9% vs. 5.5±3.3%; p<0.03) coupled with lower relative drainage through the internal jugular veins (56±21 vs. 79±9%; p<0.001). Mean MR-ICP was significantly higher in MTBI (12.5±2.9 mmHg vs. 8.8±2.0 mmHg; p<0.0007) and ICC was significantly lower in subjects with MTBI (5.85±1.4 vs. controls 8.38±1.9; p<0.0007).

The mechanism that leads to increased secondary venous outflow associated with higher MR-ICP in MTBI is not yet understood. However, previously reported morphological and functional changes (e.g. venous vasodilation and vasogenesis) in the cerebral vasculature of MTBI may alter cerebral hemodynamics, which in turn may influence cerebral venous drainage.

Microstructural damage to the brain tissue leading to changes in physiological characteristics might be the cause of a decreased intracranial compliance and a slightly elevated MR-ICP.

Koerte, I, Pomschar, A, Schick, M, Lee, S, Ertl-Wagner, B, Alperin, N, Plesnila, N, Straube, A, Heinen, F, Reiser, M, Pronounced Secondary Venous Drainage and Increased Intracranial Pressure after Mild Traumatic Brain Injury.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11007826.html