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Jugular Vein Obstruction caused by turning of the head--
Posted: Tue Apr 06, 2010 7:50 pm
by cheerleader
Something to think about...especially concerning head posture when sleeping, when the jugulars are utilized the most. Also for those utilizing inclined bed therapy or thinking about postural relationship to jugular flow- this is a good study to read.
CharlesA.Gooding1Gary K. Stima&
In vivo and cadaver studies demonstrated that turning the head to one side results in torsion and compression of the ipsilateral internal jugular vein. This can obstruct venous drainage from the head and cause increased intracranial pressure in patients who have had ligation or resection of the contralateral jugular vein or who have maldevelopment of the contralateral dural sinuses.
Our studies cleanly demonstrated that turning the head to one side results in torsion-compression of the ipsilatenal internal jugular vein, which could have hemodynamically significant consequences. Though many collateral channels for venous drainage of the head are available to compensate, they may be severely compromised if resection, ligation, or cathetenization of the vein, on anatomic variations in the venous channels have already obstructed the contralatenal internal jugular vein.
http://www.ajronline.org/cgi/reprint/142/2/403.pdf
cheer
Posted: Tue Apr 06, 2010 8:17 pm
by PCakes
incredible.. absolutely incredible.. i've asked this very question of many.. inspired by my own habit of stomach sleeping.. surfed.. read.. researched without success.. and then poof.. here it is... once again brought to us by our friendly neighbourhood 'cheerleader'.. thank you
Posted: Tue Apr 06, 2010 8:26 pm
by bluesky63
Naturally I remember that I loved sleeping on my stomach -- and when did that become impossible? When I was pregnant and breastfeeding!
The plot thickens!
Thank you, Cheerleader, as always!
Posted: Tue Apr 06, 2010 8:37 pm
by PCakes
hi bluesky.. sorry..could you help me understand the stomach sleeping to pregnancy/ breastfeeding not being able to, connection? Did you feel better while pregnant/ breastfeeding? ..hmm hope that's not too personal...puzzle..pieces..looking for....thanks
Posted: Tue Apr 06, 2010 8:43 pm
by muse
Good find cheer. Dr. Schelling told me some times ago the same and he said it would be worth while to think about to wear a sort of a “neck brace” over the day to avoid that problem until I get fixed my higher up stenosis of the VJ.
I do the inclined bed therapy as well so for me it isn’t further possible to sleep on the belly anymore (back problems). What’s good because I did this my whole live and I was always turning the head to one side.
Best
Arne ...sleeping always on her hips now
http://www.csvi-ms.net/en
Posted: Tue Apr 06, 2010 8:47 pm
by ndwannabe
Thank you! Having started the IBT I almost instinctively was trying to position my head every so other way, finding the best position. You just helped me
Posted: Wed Apr 07, 2010 4:17 am
by bluesky63
Sorry if that seemed mysterious. There's a general sense that MS improves during pregnancy, and there are also studies that show improvement if someone breastfeeds instead of weaning immediately. I was being a little facetious because there are multiple factors that could be involved (blood volume increasing, different hormones circulating, etc.) but one thing that becomes impossible if you're pregnant is sleeping on a large stomach.
And if you're breastfeeding, you can't sleep on your stomach or you'll get a breast infection (or at least I would have).
But really I was don't know if it could be that simple and mechanical with all the complex factors at play.
Posted: Wed Apr 07, 2010 8:50 am
by WeWillBeatMS
Thanks for posting this informaion Cheerleader. I have been plagued by nighttime extreme headaches for years. My head just feels like it's going to explode at times at night. I have even described it to a few neurologists as feeling like my brain is swelling as if I have encephilits or something. I tell people that I feel like I'm crawling into my coffin when I get into bed. In addition to the pain I get extremely cold at times and then hot and sweating other times. Diziness gets worse for me at night as well. I am scheduled for my first MRV in two days for Friday. Hope to see the evidence in black and white finally.
faith, hope & love
Posted: Wed Apr 07, 2010 10:33 am
by frodo
Is it known which one closes? I mean, if I turn my head to the right, is the right IJV the one that closes? or the left instead? Maybe it could be even possible that one closes and the other opens.
Please cheer, you are in contact with doctors. Ask them this.
Re: Jugular Vein Obstruction caused by turning of the head--
Posted: Wed Apr 07, 2010 11:02 am
by Cece
cheerleader wrote:
In vivo and cadaver studies demonstrated that turning the head to one side results in torsion and compression of the ipsilateral internal jugular vein.
frodo, there's the answer...I had to learn the word ipsilateral earlier on this site, when I read that occlusion in a jugular may cause swelling in the ipsilateral arm/hand...it means same side. I have issues when my head is turned to the left or when I try to lie down on my left side, so it may be that my left jugular is the affected one. Lots to chew on.
Posted: Wed Apr 07, 2010 11:05 am
by ikulo
Could this explain why some MSers don't have stenosis when tested? meaning, there is no permanent stenosed vein, but it is just temporarily closed off while sleeping on your stomach for example?
Re: Jugular Vein Obstruction caused by turning of the head--
Posted: Wed Apr 07, 2010 12:05 pm
by frodo
Cece wrote:cheerleader wrote:
In vivo and cadaver studies demonstrated that turning the head to one side results in torsion and compression of the ipsilateral internal jugular vein.
frodo, there's the answer...I had to learn the word ipsilateral earlier on this site, when I read that occlusion in a jugular may cause swelling in the ipsilateral arm/hand...it means same side. I have issues when my head is turned to the left or when I try to lie down on my left side, so it may be that my left jugular is the affected one. Lots to chew on.
God!! I would have never guessed that word!!!
Thanks
Posted: Wed Apr 07, 2010 12:13 pm
by Cece
"In each instance of turning, the contralatenal jugular vein remained
patent."
So...the same side vein closes, the other side stays open...
Posted: Wed Apr 07, 2010 12:16 pm
by PCakes
ikulo..i was wondering the same thing.. and it might explain why IBT helps..which it does seem to do for me..
Posted: Thu Apr 08, 2010 9:40 am
by zap
aha! my intuition (on this, at least) seems to have been validated!!
http://www.thisisms.com/ftopicp-71195.html
http://www.thisisms.com/ftopicp-98820-s ... html#98820
But now that's it's more than a hunch of mine, I can hopefully muster the will to sleep on my back most or all of the time, rather than just rarely ...
I'm another stomach sleeper - if I'm lucky, on my side. I have stuffy sinuses and a swollen-feeling head many mornings, and have long suspected, even before MS disgnosis, that I should try to sleep on my back instead ....
(And when I am sleeping on my face with my head cranked way to the right, closing off the right jugular, what's going on with the left side? It's being smashed against a pillow ... hmmm)
I've also noticed that if I turn my head hard to the right (like to look at my right shoulder/back) that I feel lightheaded and pressurized after a short while and need to look forward again ...