Skip to main content
SpringerLink
Log in

Studies of Jugular Pressure

  • Chapter
Book cover Monitoring of Cerebral and Spinal Haemodynamics During Neurosurgery

  • 887 Accesses

Abstract

It is well known that neck compression increases jugular venous pressure cranial to the compression and consequently ICP. Thus, the Queckenstedt manoeuvre, bilateral neck compression and coughing inevitably result in an increase in ICP. In contrast, clinical studies, including patients with space-occupying cerebral processes, have demonstrated that elevation of the head results in a decrease in ICP, while the head down position results in an increase in ICP. To what extent, however, rotation of the head results in changes in jugular venous pressure is sparsely investigated. In this chapter the results of two studies of jugular pressure and the effect of neck movement, and the influence of the sitting position with either anti-G-suit or application of positive end-expiratory pressure are presented.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Albin MS, Babinski MF, Gilbert J et al (1983) Venous air embolism is not restricted to neurosurgery. Anesthesiology 53:151

    Article  Google Scholar 

  • Bithal PK, Pandia MP, Dash HH et al (2004) Comparative incidence of venous air embolism and associated hypotension in adults and children operated for neurosurgery in the sitting position. Eur J Anaesthesiol 21:517–522

    Article  PubMed  CAS  Google Scholar 

  • Black S, Ockert DB, Oliver WC et al (1988) Outcome following posterior fossa craniectomy in patients in the sitting or horizontal position. Anesthesiology 69:49–56

    Article  PubMed  CAS  Google Scholar 

  • Black S, Cucchiara RF, Nishimura RA et al (1989) Parameters affecting occurrence of paradoxical air embolism. Anesthesiology 71:235–241

    Article  PubMed  CAS  Google Scholar 

  • Black S, Muzzi DA, Nishimura RA et al (1990) Preoperative and intraoperative echocardiography to detect right-to-left shunt in patients undergoing neurosurgical procedures in the sitting position. Anesthesiology 72:436–438

    Article  PubMed  CAS  Google Scholar 

  • Buckland EW, Manners JM (1976) Venous air embolism during neurosurgery. Anaesthesia 31:633–643

    Article  PubMed  CAS  Google Scholar 

  • Domainque CM (2005a) Neurosurgery in the sitting position: a case series. Anaesth Intensive Care 33:332–335

    Google Scholar 

  • Domainque CM (2005b) Anaesthesia for neurosurgery in the sitting position: a practical approach. Anaesth Intensive Care 33:323–331

    Google Scholar 

  • Engelhardt M, Folkers W, Brenke C et al (2006) Neurosurgical operations with the patients in sitting position: analysis of risk factors using transcranial Doppler sonography. Br J Anaesth 96:467–472

    Article  PubMed  CAS  Google Scholar 

  • Ericsson JA, Gottlieb JD, Sweet RB (1964) Closed chest massage in the treatment of venous air embolism. N Engl J Med 270:1353–1354

    PubMed  CAS  Google Scholar 

  • Feldman Z, Kanter M, Robertson CS et al (1992) Effect of head elevation in intracranial pressure, cerebral perfusion pressure, and cerebral blood flow in head-injured patients. J Neurosurg 76:207–211

    PubMed  CAS  Google Scholar 

  • Girard F, Ruel M, McKenty S et al (2003) Incidences of venous air embolism and patent foramen ovale among patients undergoing selective peripheral denervation in the sitting position. Neurosurgery 53:316–319

    Article  PubMed  Google Scholar 

  • Goldberg RN, Joshi A, Moscoso P (1983) The effect of head position in intracranial pressure in the neonate. Crit Care Med 11:428–430

    Article  PubMed  CAS  Google Scholar 

  • Harrison EA, Mackersie A, McEwan A (2002) The sitting position for neurosurgery in children: a review of 16 years’ experience. Br J Anaesth 88:1–3

    Article  Google Scholar 

  • Haure P, Cold GE, Hansen TM et al (2003) The ICP-lowering effect of 10 degrees reverse Trendelenburg position during craniotomy is stable during a 10 minute period. J Neurosurg Anesthesiol 15:297–301

    Article  PubMed  Google Scholar 

  • Hewer AJH, Loque V (1962) Methods of increasing the safety of neuroanaesthesia in the sitting position. Anaesthesia 17:476–482

    Article  PubMed  CAS  Google Scholar 

  • Hulme A, Cooper R (1976) The effects of head position and jugular vein compression (JVC) on intracranial pressure (ICP). A clinical study. In: Beks JWF, Bosch DA, Brock M (eds) Intracranial pressure III. Springer, Berlin, pp 259–263

    Google Scholar 

  • Iwabuchi T, Sobata E, Suzuki K et al (1983) Dural sinus pressure as related to neurosurgical positions. Neurosurgery 12:203–207

    Article  PubMed  CAS  Google Scholar 

  • Kenning JA, Toutant SM, Sauders RL (1981) Upright patient positioning in the management of intracranial hypertension. Surg Neurol 15:148–152

    Article  PubMed  CAS  Google Scholar 

  • Lee ST (1989) Intracranial pressure changes during positioning of patients with severe head injury. Heart Lung 32:1288–1291

    Google Scholar 

  • Leighton SB, Winston K (1994) Cerebrospinal fluid pressure as a function of body position in dogs. Neurol Res 16:439–442

    PubMed  CAS  Google Scholar 

  • Leivers D, Spilsbury RA, Young JVI (1971) Air embolism during surgery in the sitting position. Br J Anaesth 43:84–90

    Article  PubMed  CAS  Google Scholar 

  • Leslie K, Hui R, Kaye AH (2006) Venous air embolism and the sitting position: a case series. J Clin Neurosci 13:419–422

    Article  PubMed  CAS  Google Scholar 

  • Matjasko J, Petrozza P, Cohen M et al (1985) Anesthesia and surgery in the seated position: analysis of 544 cases. Neurosurgery 17:695–702

    Article  PubMed  CAS  Google Scholar 

  • Mavrocordatos P, Bissonnette B, Ravussin P (2000) Effects of neck position and head elevation on intracranial pressure in anaesthetized neurosurgical patients. J Neurosurg Anesthesiol 12:10–14

    Article  PubMed  CAS  Google Scholar 

  • Michenfelder JD, Martins JT, Alterburg BM (1969) Air embolism during neurosurgery: an evaluation of right-arterial catheters for diagnosis and treatment. J Am Med Assoc 298:1353–1358

    Article  Google Scholar 

  • O’Higgins JW (1970) Air embolism during neurosurgery. Br J Anaesth 42:459–462

    Article  PubMed  CAS  Google Scholar 

  • Porter JM, Pidgeon C, Cunningham AJ (1999) The sitting position in neurosurgery: a critical appraisal. Br J Anaesth 82:117–128

    PubMed  CAS  Google Scholar 

  • Rolighed Larsen J, Haure P, Cold GE (2002) Reverse Trendelenburg position reduces intracranial pressure during craniotomy. J Neurosurg Anesthesiol 14:16–21

    Article  PubMed  Google Scholar 

  • Ropper MJ, Coley IB (1982) Cerebral perfusion pressure, intracranial pressure, and compliance. Neurology 32:1288–1291

    PubMed  CAS  Google Scholar 

  • Rosner MJ, Coley IB (1986) Cerebral perfusion pressure, intracranial pressure, and head elevation. J Neurosurg 65:636–641

    PubMed  CAS  Google Scholar 

  • Sale JP (1984) Prevention of air embolism during sitting neurosurgery. The use of inflatable venous neck tourniquet. Anaesthesia 39:795–799

    Article  PubMed  CAS  Google Scholar 

  • Schmitt HJ, Hemmerling TM (2002) Venous air emboli occur during release of positive end expiratory pressure and repositioning after sitting surgery. Anesth Analg 94:400–403

    Article  PubMed  Google Scholar 

  • Schneider F, Franke R, Lanksch WR et al (1993) Influence of body position and cerebral and cerebral perfusion pressure. Acta Neurochir 59:107–112

    CAS  Google Scholar 

  • Sørensen J, Troelsen S, Kaalund J (1990) Changes in blood gases during venous air embolism. Eur J Anesthesiol 7:467–471

    Google Scholar 

  • Standefer M, Bay JW, Trusso R (1984) G position in neurosurgery: a retrospective analysis of 488 cases. Neurosurgery 14:649–658

    Article  PubMed  CAS  Google Scholar 

  • Stendel R, Gramm HJ, Schroeder K et al (2000) Transcranial Doppler ultrasonography as a screening technique for detection of a patent foramen ovale before surgery in the sitting position. Anesthesiology 93:971–975

    Article  PubMed  CAS  Google Scholar 

  • Tankisi A, Cold GE (2007) Optimal reverse Trendelenburg position in patients undergoing craniotomy for cerebral tumours. J Neurosurg 106:239–244

    Article  PubMed  Google Scholar 

  • Tankisi A, Rolighed Larsen J, Rasmussen M et al (2002) The effect of 10 degrees reverse Trendelenburg position on ICP and CPP in prone positioned patients subjected to craniotomy for occipital or cerebellar tumours. Acta Neurochir 144:665–670

    Article  CAS  Google Scholar 

  • Tankisi A, Rasmusssen M, Juul N (2006) The effects of 10 degrees reverse Trendelenburg position on subdural intracranial pressure and cerebral perfusion pressure in patients subjected to craniotomy for cerebral aneurysm. J Neurosurg Anesthesiol 18:11–17

    Article  PubMed  Google Scholar 

  • Tausk HC, Miller R(1983) Anaesthesia for posterior fossa surgery in the sitting position. Bull N Y Acad Med 59:771–783

    PubMed  CAS  Google Scholar 

  • Toung TJ, Miyabe M, McShane AJ et al (1988) Effect of PEEP and jugular venous compression on canine cerebral blood flow and oxygen consumption in the head elevated position. Anesthesiology 68:53–58

    Article  PubMed  CAS  Google Scholar 

  • Toung TJ, Aizawa H, Traystman RJ (2000) Effects of positive end-expiratory pressure ventilation on cerebral venous pressure with head elevation in dogs. J Appl Physiol 88:655–661

    PubMed  CAS  Google Scholar 

  • Watson G (1974) Effect of head rotation on jugular vein blood flow. Arch Dis Child 49:237–239

    Article  PubMed  CAS  Google Scholar 

  • William A, Coyne SM (1993) Effects of neck position in intracranial pressure. Am J Crit Care 2:68–71

    Google Scholar 

  • Yoshida A, Shima T, Okada Y et al (1993) Effects of postural changes on epidural pressure and cerebral perfusion pressure in patients with serious intracranial lesions. In: Avezaat CJJ, Eijndhoven JHM, Maas AIR, Tans JTJ (eds) Intracranial pressure VIII. Springer, Berlin, pp 433–436

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hojkolvej 2, 8210, Aarhus V, Denmark

    Georg E. Cold

  2. Department of Neuroanaesthesia, Aarhus University Hospital, Norrebrogade 44, 8000, Aarhus C, Denmark

    Niels Juul

Authors
  1. Georg E. Cold
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Niels Juul
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Hojkolvej 2, 8210, Aarhus V, Denmark

    Georg E. Cold

  2. Department of Neuroanaesthesia, Aarhus University Hospital, Norrebrogade 44, 8000, Aarhus C, Denmark

    Niels Juul

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Cold, G., Juul, N. (2008). Studies of Jugular Pressure. In: Cold, G., Juul, N. (eds) Monitoring of Cerebral and Spinal Haemodynamics During Neurosurgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-77873-8_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-77873-8_22

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-77872-1

  • Online ISBN: 978-3-540-77873-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation