Venous Doppler Ultrasound Assessment of the Parasellar Region

Abstract

The purpose of this report is to present normal values for venous blood flow velocities from the parasellar region using transcranial Doppler ultrasound (2-MHz transducer) with both transtemporal and transorbital approaches and to examine the nature of previously reported low-pulsatility signals with velocities in the arterial range from this area. Forty-three subjects ranging in age from 18 to 56 years (mean ± SD, 31.9 ± 10.1 years) were examined. In all subjects, a venous signal directed away from the probe with the source lateral to the internal carotid artery siphon was detected on at least one side. A total of 72 parasellar venous signals were insonated. Signals were considered to belong to the main inflow and outflow vessels of the cavernous sinus. The mean blood flow velocity ranged from 6 to 81 cm/s (mean ± SD, 27.3 ± 17.4 cm/s). Typical transients in the Valsalva test confirmed the venous character of the signals. No significant gender, side-to-side or age dependency was observed. A separate analysis was done for venous high-velocity signals defined by a mean blood flow velocity greater than 30 cm/s. They were detected in 21 out of 43 subjects (48.9%) via a transtemporal approach and in 6 of them (14%) via the transorbital route, too. Again, no significant gender, side-to-side or age dependency was noted. In summary, we found a greater variability of venous blood flow velocities in the parasellar region compared to other basal cerebral veins, e.g. the basal vein of Rosenthal. The previously reported low-pulsatility signals with velocities in the arterial range proved to be of venous origin.

Intracranial Venous Hemodynamics Is a Factor Related to a Favorable Outcome in Cerebral Venous Thrombosis

“…Although TCCS has disadvantages in this respect, the most important being that not all the intracranial venous structures can be examined, it offers unlimited repeatability because of its noninvasiveness and cost effectiveness. Venous TCCS has been validated with extensive sets of normative data 5,6,9 showing excellent agreement on normal FVs and flow directions between the different studies. In patients Ͻ50 years of age, the identification rates are high even without echocontrast enhancement.…”

“…For classification of the TCCS results into normal or pathological, previously published normative data on FVs and flow directions have been used. [5][6][7] For a given vessel, a pathological result was assumed when flow direction was reversed or the FV was increased beyond the mean plus 2 SD.…”

Analysis of CO 2 Vasomotor Reactivity and Vessel Diameter Changes by Simultaneous Venous and Arterial Doppler Recordings

“…A venous signal, slightly more lateral and anterior with a low-pulsatile flow away from the probe at a depth of 40 to 50 mm, was considered to represent the SPS. 3 Only subjects who demonstrated a stable venous signal, allowing reliable recordings, were included into the study. Mean blood flow velocities (V MCA and V SPS ) were recorded in centimeters per second.…”

Monitoring of Venous Hemodynamics in Patients With Cerebral Venous Thrombosis by Transcranial Doppler Ultrasound

“…They were defined by their proximity to the internal carotid artery siphon and considered to correspond to the main inflow vessels to the cavernous sinus (CS), especially to the sphenoparietal sinus or to a sylvian vein. 7 The inferior petrosal sinus (IPS) was detected by using the suboccipital approach by its proximity to the basilar artery at a depth of about 80 to 90 mm with a flow directed toward the probe. 8 The V mean (the time-averaged mean velocity over the cardiac cycle of the spectral outline) was automatically recorded in centimeters per second.…”