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October 1931

ANATOMIC VARIATIONS OF THE CRANIAL VENOUS SINUSES: THEIR RELATION TO THE EFFECT OF JUGULAR COMPRESSION IN LUMBAR MANOMETRIC TESTS

Author Affiliations

BOSTON

From the Anatomic Laboratory of Tufts College Medical School, and the Examiner's Office.

Arch NeurPsych. 1931;26(4):801-814. doi:10.1001/archneurpsyc.1931.02230100119010
Abstract

When one compresses the internal jugular veins, the obstruction to the outflow of the cranial circulation is reflected in a rise of the cerebrospinal fluid pressure. This principle is the basis of the Queckenstedt test,1 in which the rise of spinal fluid pressure, noted by means of a manometer attached to the lumbar puncture needle, denotes the patency, or absence of block, in the subarachnoid space. In 1925, Tobey and Ayer2 modified this test for the detection of thrombosis of the transverse or lateral sinus. Briefly, their test depends on the fact that if the transverse sinus, forming the chief intracranial tributary of the internal jugular vein, is occluded, it will not act as an outflow for the cerebral circulation. Hence, unilateral compression of the vein of the affected side will not produce increased obstruction to the circulation, and consequently there will not be a rise in the

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