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In addition, the diploic veins drain the blood between layers of bone in the skull. Emissary veins connect the veins near the surface of the skull to the diploic veins and venous sinuses. All the blood is drained into the meningeal sinuses, which mainly drain into the internal jugular vein. Usually, the right jugular vein is the dominant one, receiving most of the blood from the brain. The veins and sinuses of the brain lack valves. Pressure of drainage vessels in the neck is directly transmitted to intracranial venous structures (Fig.

Common symptoms for both central and nephrogenic DI are hypernatremia, hyperosmolality, and dilute polyuria. Central DI presents with severely reduced urine osmolatity: <200 mOsm/L versus 200–500 mOsm/L with nephrogenic DI. 6 list strategies for initial management of DI. H. 5 Diagnostic criteria for DI • Classic triphasic response (which can confuse later interpretation of SIADH/hyponatremia) evolves over days: Polyuria (often >1 L/h) and hypernatramia followed by reduced urine output (presumed to be secondary to ADH release from dying cells) and hyponatremia, and finally resolution or permanence of DI • Frequently transient or permanent (without associated phases) • Commonly presents > 12 h after surgery • Rarely presents intraoperatively: Intraoperative presentation (phase 1) is associate with hypovolemia ↓Plasma volume may ↑ risk of venous air embolism during surgery • Differentiate polyuria vs.

Lesions above the medullary decussation 10 P. Sharma and F. Sieber Vertebral artery Basilar artery Anterior spinal artery Ascending cervical artery Radiculo-medullary artery of C3-C4 Thyrocervical trunk Radiculo-medullary artery of C5-C6 Deep cervical artery Radiculo-medullary artery of C7-C8 Costocervical trunk Subclavian artery Radiculo-medullary artery of T3-T4 Posterior spinal artery Radiculo-medullary artery of T11-T12 or artery of Adamkiewicz Radicular Lumbosacral arteries Medial sacral artery Right lateral sacral artery Right internal iliac artery Fig.

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Adult & Pediatric Spine

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