MR Elastography Can Be Used to Measure Brain Stiffness Changes as a Result of Altered Cranial Venous Drainage During Jugular Compression

Abstract

BACKGROUND AND PURPOSE:Compressing the internal jugular veins can reverse ventriculomegaly in the syndrome of inappropriately low pressure acute hydrocephalus, and it has been suggested that this works by "stiffening" the brain tissue. Jugular compression may also alter blood and CSF flow in other conditions. We aimed to understand the effect of jugular compression on brain tissue stiffness and CSF flow.

Analysis of head impact exposure and brain microstructure response in a season-long application of a jugular vein compression collar: a prospective, neuroimaging investigation in American football

“…Much like the effect of collar in animal experiment, jugular vein compression in humans results in increased volume of the venous capacitance vessels of the cranium 16. Filling the compensatory reserve volume17 of the brain and spinal column appears to increase brain stiffness during jugular compression, as assessed by magnetic resonance elastography 18. Based on prior physiological models, we hypothesised that this would create a cradling effect to increase the brain's resistance to movement or inertia, (ie, slosh mitigation of the brain inside the skull), potentially protecting the brain from external head impacts 11.…”

A longitudinal magnetic resonance elastography study of murine brain tumors following radiation therapy

“…Magnetic resonance elastography (MRE) can provide important insights into tissue mechanical properties by imaging the propagation of acoustic waves within the tissue (Atay et al , 2008; Clayton et al , 2012; Sinkus, 2014; Johnson et al , 2013; John et al , 2012; Muthupillai et al , 1995; Sack et al , 2004; Sinkus et al , 2000; Hatt et al , 2015). MRE can detect differences in tumor stiffness relative to surrounding tissue (Reiss-Zimmermann et al, 2014; Simon et al, 2013; Xu et al, 2007; Krouskop et al, 1998; McKnight et al, 2002; Sinkus et al, 2005; Barton et al, 1999; Venkatesh et al, 2008) and has been applied clinically to diagnose liver fibrosis (Yin et al , 2007; Huwart et al , 2006; Wang et al , 2011).…”

Magnetic Resonance Elastography Demonstrating Low Brain Stiffness in a Patient with Low-Pressure Hydrocephalus: Case Report

“…This suggests that the brain softness associated with the LPH state is not immediately reversible. We also reference a recent work by Hatt et al [34] who found jugular compression through neck wrapping did not significantly change brain tissue stiffness measured with MRE at 30 Hz, as might be expected as it is a therapeutic maneuver used successfully in the management of LPH [4,18]. This further underscores that tissue stiffness itself, whether it causes or is caused by the LPH syndrome, is not the sole source of symptomology in the condition.…”