valsalva maneuver, posture

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

valsalva maneuver, posture

Postby zap » Tue Jun 02, 2009 1:41 pm

Since I don't think I will be having surgery anytime really soon, I have been poking around a bit seeing what I could learn about how posture might affect the ability of the jugular veins to drain the brain - with the notion that certain positions might be problematic (specifically wondering about computer-hunch position, but havent found any answers on that yet)

I'm finding some interesting stuff about how the jugulars collapse in normal people under some conditions - and how the "valsalva manuever" can affect jugular flow ...

I would love to hear from people more knowledgeable than I, if they also look into it ... because to be honest, I can't tell up from down anymore, it seems like this stuff has to tie in somehow, but damned if I can nail it down right now at work!

http://jp.physoc.org/content/560/1/317.full

http://www.ncbi.nlm.nih.gov/pubmed/12602443

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Will inducing a yawn be helpful - post exercise or hot bath? You tell me ... my brain hurts.

Sorry if this is totally useless!
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Postby whyRwehere » Tue Jun 02, 2009 11:40 pm

well, I have nothing to add, but that I found it very interesting reading. Will have to finish it later, though.
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Postby mrhodes40 » Wed Jun 03, 2009 6:11 am

Oh man Dr zamboni references things of this nature so he is aware of these kinds of materials.

The first paper is about different postures and whether the jugulars or the vertebral veins are the main pathway out of the brain. When you lay down the vertebral veins are less than the jugs and they do all the draining, standing up the jugs take very little blood but the vertebrals take most of it. Unless you are doing a valsalva manoever then the jugs open back up. These are known things, normal function.

If you have an anomaly in the hemodynamics such as the jugulars blocked, then this normal pattern is changed and the vertebrals are taking the oad all the time even when they should not be doing so.

The second paper is about breathing and how that impacts the circulation. Zamboni talks about that as well in that the thoracic pump is part of the venous drainage of the head, although they are talking about PPB it is the same. Good deep breaths in other words help drainage.

The third one is about patients with head injury-coma- the question was do we keep the head of the bed up or not as the traditional point of view was to keep it up but the concern was if we keep the head up then maybe the oxygenated blood does not get in there as well as it should. The answer was it is OK to keep the head of the bed up.

the fourth one required a subscription but my guess is that it is immaterial for us as the question posed by the authors was whether or not venipucture affects the jugular. Venipucture is putting a needle in it.

The fifth one is about using the valsalva manoever to break a tachycardia under direction of a physician. meaningless for us.

Overall getting good deep breaths is a good thing as it aids cerebral drainage. Posture is not actually addressed in any of those papers, but probably as a guess sitting scrunched/hunched is not a good thing as it impairs good breathing.
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Postby akaheather » Wed Jun 03, 2009 1:54 pm

Sit up straight and breathe. I think I can do that. Would it help if we chewed gum at the same time? :lol: That might be a little more difficult. :wink:
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Postby akaheather » Wed Jun 03, 2009 2:01 pm

I thought someone mentioned aspirin at one point. Was there a consensus as to whether or not aspirin would help?

I know it would not be long term solution. Just curious if it could help a smidgen while we wait for the medical community to get on board.
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