Head Elevation, Cerebral Venous System, and Intracranial Pressure: Review and Hypothesis

Background Facilitation of venous outflow from the brain is largely believed to be responsible for beneficial effect head elevation on intracranial pressure (ICP). However, impact cerebral perfusion can deleterious. Although adverse obstructing in setting hypertension well documented, converse (improvement with augmented drainage) has not been demonstrated. Our hypothesis that active augmentation ICP, although unknown, could potentially under conditions hypertension. Methods Published literature was perused ascertain known relationships between elevation, pressure, and system. Results Head benefits ICP control improved via various networks craniospinal cerebrospinal fluid displacement; but patients severe spectrum have a high likelihood experiencing decline especially beyond 30°. In addition, interaction autoregulation, compliance, pulse amplitude, becomes increasingly dyssynchronous severely affected brain. detrimental effects drainage are possibility augmenting by withdrawal sagittal sinus blood described previously. Conclusion There exist potential role targeted aspiration favorably influencing increased conditions, without significant risk perfusion.