, Volume 46, Issue 7, pp 565–570

How does the blood leave the brain? A systematic ultrasound analysis of cerebral venous drainage patterns


    • Department of NeurologyUniversity Hospital Charité
  • Stephan J. Schreiber
    • Department of NeurologyUniversity Hospital Charité
  • Thomas von Münster
    • Department of NeurologyUniversity Hospital Charité
  • Jörg Rademacher
    • Department of NeurologyUniversity Hospital Charité
  • Randolf Klingebiel
    • Department of NeuroradiologyUniversity Hospital Charité
  • José M. Valdueza
    • Department of NeurologyUniversity Hospital Charité
Diagnostic Neuroradiology

DOI: 10.1007/s00234-004-1213-3

Cite this article as:
Doepp, F., Schreiber, S.J., von Münster, T. et al. Neuroradiology (2004) 46: 565. doi:10.1007/s00234-004-1213-3


The internal jugular veins are considered to be the main pathways of cerebral blood drainage. However, angiographic and anatomical studies show a wide anatomical variability and varying degrees of jugular and non-jugular venous drainage. The study systematically analyses the types and prevalence of human cerebral venous outflow patterns by ultrasound and MRI. Fifty healthy volunteers (21 females; 29 males; mean age 27±7 years) were studied by color-coded duplex sonography. Venous blood volume flow was measured in both internal jugular and vertebral veins in the supine position. Furthermore, the global arterial cerebral blood volume flow was calculated as the sum of volume flows in both internal carotid and vertebral arteries. Three types of venous drainage patterns were defined: a total jugular volume flow of more than 2/3 (type 1), between 1/3 and 2/3 (type 2) and less than 1/3 (type 3) of the global arterial blood flow. 2D TOF MR-venography was performed exemplarily in one subject with type-1 and in two subjects with type-3 drainage. Type-1 drainage was present in 36 subjects (72%), type 2 in 11 subjects (22%) and type 3 in 3 subjects (6%). In the majority of subjects in our study population, the internal jugular veins were indeed the main drainage vessels in the supine body position. However, a predominantly non-jugular drainage pattern was found in approximately 6% of subjects.


Cerebral venous drainageColor-coded duplex sonographyExtrajugular venous system

Copyright information

© Springer-Verlag 2004