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It is part of what has been termed the cranial microgravity response (CMR). However, the physiological mechanisms underlying these changes remain unclear. We employed a ~2-h, \u221210\u00b0 head-down tilt (HDT) paradigm to investigate the immediate effects of cephalad fluid shift on cranial venous outflow, cephalic venous vasculature, and brain temperature. Twenty-one adults (26.6\u2009\u00b1\u20092.4\u2009years) underwent four MRI sessions combining 4D-flow measurements, susceptibility-weighed imaging, Time-of-Flight angiography, and MR Spectroscopy. HDT resulted in a significant increase in internal jugular vein cross-sectional area (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001), decreased jugular vein flow velocity (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and normalized mean flowrate (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001), a volumetric expansion of the main cervical arteries (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001), and a reduction in superior sagittal sinus flow velocity (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.03). We also found a significant increase in global brain temperature after HDT (0.33\u00b0C\u2009\u00b1\u20090.28\u00b0C;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001). These findings provide converging evidence for compromised cranial venous outflow in simulated microgravity, suggesting an upstream impact on the cerebral venous vasculature and thermal homeostasis of the head. Our setup now offers a comprehensive and fast-turnaround framework for the testing of countermeasures against the CMR.\n                  <\/jats:p>","DOI":"10.1177\/0271678x251400470","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T06:01:11Z","timestamp":1765173671000},"page":"1175-1190","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["The immediate functional and structural consequences of head-down tilt on the cranial venous vasculature and brain temperature"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2472-0386","authenticated-orcid":false,"given":"Mehul","family":"Nimpal","sequence":"first","affiliation":[{"name":"Institute for Neuroradiology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Winter","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, Institute of Physics, University of Greifswald, Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Schnell","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, Institute of Physics, University of Greifswald, Greifswald, Germany"},{"name":"Department of Radiology, Northwestern University, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3729-4570","authenticated-orcid":false,"given":"Peter","family":"zu Eulenburg","sequence":"additional","affiliation":[{"name":"Institute for Neuroradiology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,7]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1088\/0143-0815\/10\/3\/001"},{"key":"e_1_3_3_3_2","article-title":"Space shuttle inflight and postflight fluid shifts measured by leg volume changes","volume":"58","author":"Moore TP","year":"1987","unstructured":"Moore TP, Thornton WE. 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