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Disc Structure and Function
Published in Peter Ghosh, The Biology of the Intervertebral Disc, 2019
It appears that the cancellous bone, which forms the interior of the vertebral bodies, is also compressed by the axial component of the forces generated by muscular contraction. Indeed, the vertebral end-plates may bulge into the vertebral bodies indicating that the nucleus, when contained by the annulus, is less compressible than the cancellous bone.23,138,140 Compression of intervertebral joints to failure in vitro invariably leads to fracture of the vertebral bodies and cracking of the end-plates, rather than to damage of the annulus,98,111,140,143 similar fractures occur in vivo144 and lumbar vertebrae somtimes show signs of trabecular microfractures.145,146 During in vitro compression of intervertebral joints, blood is squeezed from the bone through the perivertebral sinuses.140 Blood flow in vivo might then provide a mechanism for dissipating some of the energy stored by a compressed spine and, hence, help to protect against fracture.23,140 This suggestion is consistent with the considerable capacity of vertebral veins, which “must be considered emissary veins rather than nutrient veins draining the blood,147 and with their absence of valves, so that blood can flow back into the vertebrae to restore their mechanical properties.23
The Crucial Role of Craniofacial Growth on Airway, Sleep, and the Temporomandibular Joint
Published in Aruna Bakhru, Nutrition and Integrative Medicine, 2018
CSF comes from arterial blood that has been filtered through the blood–brain barrier to the point where it is mostly water. CSF then leaves the brain through the venous system. Most of the CSF produced by the brain eventually makes its way up to the superior sagittal sinus where it empties into the venous system, the rest follows routes along cranial nerves, spinal nerves, and the lymphatic system. The CSF that leaves the brain on its way down to the cord must first pass through the tight neural (spinal) canal of the upper cervical spine. Likewise, on its return trip back to the brain, it must again pass through the neural canal of the upper cervical spine. Therefore, the upper cervical spine is a critical link in the flow of CSF between the subarachnoid space of the brain and the cord. It is vital to maintain the correct volume and flow of CSF in order to provide sufficient brain support and protection. Vertebral arteries supply the brain, and vertebral veins drain the brain. Any mechanical backups in this venous drainage system will invariably affect CSF pulsations, energy flow, and lymphatic drainage (Flanagan 2011). Figure 8.8 shows that energy flow is dependent on unimpeded flow of CSF.
Regional blood flow
Published in Burt B. Hamrell, Cardiovascular Physiology, 2018
There are four arteries that deliver almost all the blood to the brain: bilateral internal carotid and vertebral arteries. The two vertebral arteries join to form the basilar artery. There is a minor contribution from the anterior spinal artery. Venous outflow is via the internal jugular and vertebral veins.
PVP with or without microwave ablation for the treatment of painful spinal metastases from NSCLC: a retrospective case-control study
Published in International Journal of Hyperthermia, 2023
Yiming Liu, Haoyue Yuan, Sigdel Milan, Chengzhi Zhang, Xinwei Han, Dechao Jiao
The patient lay prone on a digital subtraction angiography (DSA) machine (Artis zeego with iGuide virtual navigation puncture system and C-arm CT (Siemens, Munich, Germany), and dexmedetomidine (0.5 mg/kg) and diloxin (10 mg) were intravenously infused by pump to obtain a satisfactory pain control state. All cases first underwent C-arm CT according to previous parameters [17], and iGuide navigation (Syngo X Workplace) was used to plan the puncture path. All puncture paths were selected depending on the convenience of the puncture and the operator’s experience. After local sterilization, local anesthesia was performed with 2% lidocaine (10 ml), and a 13 G puncture needle (12 cm in length, Dragon Crown Medical Products Co., Ltd. China) was advanced under real-time fluoroscopy; the correct position was confirmed by the anterior and lateral positions. A contrast agent (320 mg I/100 ml, Hengrui Medical Technology Co., Ltd.) (5 ml) was used to visualize the peripheral vertebral veins. Bone cement (polymethyl methacrylate, PMMA, Heraeus Medical GmbH, Wertheim, Germany) was injected under the real-time fluoroscopy monitor to complete PVP in Group A.
Lemierre’s syndrome in adulthood, a case report and systematic review
Published in Acta Clinica Belgica, 2021
Marco Moretti, Deborah De Geyter, Lode Goethal, Sabine D. Allard
Due to the lack of controlled studies, the role of anticoagulants in the treatment of LS is controversial. Nevertheless, they are generally recommended in the treatment of intracranial thrombophlebitis. Duration of anticoagulation is another matter of debate, with recommendations varying from 3 to 4 weeks, e.g. in cavernous sinus thromboses, to 3 to 12 months, e.g. in case of cranial venous thrombophlebitis [12,18]. The therapeutic rationale behind anticoagulation is to impede the complete blockage of deep and superficial cranial venous system. In the current review, more than half of the patients with LS were anticoagulated, mostly with LMWH. However, of the six patients with intracranial thrombophlebitis, only two were anticoagulated. Nonetheless, only two of the six patients affected by CNI thrombosis had unfavourable outcome. One patient, affected of left vertebral vein thrombosis, was anticoagulated with edoxaban and reported permanent infection-related damages. The other one, presenting with CNI septic emboli, was not anticoagulated and reported permanent neurologic disabilities. Since there are no clear guidelines on this topic, we advise to evaluate each patient on a case-by-case basis and to personalize the therapy.
Vascular aspects of multiple sclerosis: emphasis on perfusion and cardiovascular comorbidities
Published in Expert Review of Neurotherapeutics, 2019
Dejan Jakimovski, Matthew Topolski, Antonia Valentina Genovese, Bianca Weinstock - Guttman, Robert Zivadinov
Chronic cerebrospinal venous insufficiency (CCSVI) is characterized by cranial venous outflow obstruction due to either structural or functional abnormalities of the main extracranial veins (internal jugular vein, vertebral veins, and the azygos vein) [120]. The condition was initially described among MS patients, however reports of CCSVI presence within Parkinson’s patients, Meniere disease, and sudden sensorineural hearing loss have been subsequently published [121–123]. The prevalence of CCSVI significantly varied among reports and ranged from highly MS-specific occurrence to no differences between MS populations and healthy controls [120,124,125]. One of the proposed explanations for such literature disparity can be attributed to the aging of the vasculature, lack of proper training of the ultrasound readers, and low interrater reproducibility rate of the subjective Doppler examination [126,127]. Therefore, multiple guidelines, consortium opinions, and imaging techniques have attempted to improve the specificity and sensitivity of CCSVI diagnosis [128,129].