• Satoshi TsutsumiEmail author
Author’s Reply

Marian Simka et al. elegantly suggest the possible explanation for the positional change of intracranial dural venous outflow, lacking in our published study [2]. They hypothesized that abnormally stenotic valves preferentially formed in the left internal jugular vein might cause the positional alterations of the dural venous outflow. The hypothesis seems fascinating but should need further verification in a sufficiently large population. While, morphological valves have been identified in the intracranial dural sinuses and ophthalmic and facial veins [1, 3, 4]. Although these valves are commonly not visualized on currently available modalities, they can affect the venous outflow at positional changes. Anyway, the authors have successfully provided a useful framework for future studies in this field.


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  1. 1.
    Shao Y, Sun JL, Yang Y, Cui QK, Zhang QL (2009) Endoscopic and microscopic anatomy of the superior sagittal sinus and torcular herophili. J Clin Neurosci 16:421–424CrossRefGoogle Scholar
  2. 2.
    Subramaniam RM, Tress BM, King JO, Eizenberg N, Mitchell PJ (2004) Transverse sinus septum: a new aetiology of idiopathic intracranial hypertension? Australas Radiol 48:114–116CrossRefGoogle Scholar
  3. 3.
    Tsutsumi S, Ono H, Yasumoto Y, Ishii H (2019) Does the prone sleeping position affect the intracranial dural venous flow? Childs Nerv Syst 35:913–916CrossRefGoogle Scholar
  4. 4.
    Zhang J, Stringer MD (2010) Ophthalmic and facial veins are not valveless. Clin Exp Ophthalmol 38:502–510CrossRefGoogle Scholar

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© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Neurological SurgeryJuntendo University Urayasu HospitalChibaJapan

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