{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T07:25:52Z","timestamp":1789889152018,"version":"4.0.1"},"reference-count":190,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:p>Understanding the altered physiology following cerebrospinal fluid (CSF) diversion in the setting of adult hydrocephalus is important for optimizing patient care and avoiding complications. There is mounting evidence that the cerebral venous system plays a major role in intracranial pressure (ICP) dynamics especially when one takes into account the effects of postural changes, atmospheric pressure, and gravity on the craniospinal axis as a whole. An evolved mechanism acting at the cortical bridging veins, known as the \u201cStarling resistor,\u201d prevents overdrainage of cranial venous blood with upright positioning. This protective mechanism can become nonfunctional after CSF diversion, which can result in posture-related cerebral venous overdrainage through the cranial venous outflow tracts, leading to pathological states. This review article summarizes the relevant anatomical and physiological bases of the relationship between the craniospinal venous and CSF compartments and surveys complications that may be explained by the cerebral venous overdrainage phenomenon. It is hoped that this article adds a new dimension to our therapeutic methods, stimulates further research into this field, and ultimately improves our care of these patients.<\/jats:p>","DOI":"10.3171\/2016.6.focus16172","type":"journal-article","created":{"date-parts":[[2016,9,1]],"date-time":"2016-09-01T03:39:30Z","timestamp":1472701170000},"page":"E9","source":"Crossref","is-referenced-by-count":36,"title":["Cerebral venous overdrainage: an under-recognized complication of cerebrospinal fluid diversion"],"prefix":"10.3171","volume":"41","author":[{"given":"Kaveh","family":"Barami","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Kaiser Permanente Northern California, Sacramento, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus16172","series-title":"Neurocrit Care","first-page":"461","article-title":"The genesis of low pressure hydrocephalus","volume":"15","author":"Akins","year":"2011"},{"key":"b2-focus16172","series-title":"J Neurosurg","first-page":"797","article-title":"Intracranial pressure following complete removal of a small demarcated brain tumor: a model for normal intracranial pressure in humans","volume":"121","author":"Andresen","year":"2014"},{"key":"b3-focus16172","series-title":"J Neurosurg","first-page":"252","article-title":"The suboccipital cavernous sinus","volume":"86","author":"Arnautovi\u0107","year":"1997"},{"key":"b4-focus16172","series-title":"Neurosciences (Riyadh)","first-page":"305","article-title":"Remote cerebellar hemorrhage in neurosurgery","volume":"17","author":"Baeesa","year":"2012"},{"key":"b5-focus16172","series-title":"Childs Nerv Syst","first-page":"599","article-title":"The cerebral venous system and the postural regulation of intracranial pressure: implications in the management of patients with cerebrospinal fluid diversion","volume":"32","author":"Barami","year":"2016"},{"key":"b6-focus16172","series-title":"Pediatr Neurosurg","first-page":"64","article-title":"Postural changes in intracranial pressure in chronically shunted patients","volume":"33","author":"Barami","year":"2000"},{"key":"b7-focus16172","series-title":"Clin Orthop Relat Res","first-page":"4","article-title":"The function of the vertebral veins and their role in the spread of metastases. 1940","volume":"312","author":"Batson","year":"1995"},{"key":"b8-focus16172","series-title":"Neurosurgery","first-page":"851","article-title":"Relationship between valve opening pressure, body position, and intracranial pressure in normal pressure hydrocephalus: paradigm for selection of programmable valve pressure setting","volume":"55","author":"Bergsneider","year":"2004"},{"key":"b9-focus16172","series-title":"Neurocirugia (Astur)","first-page":"440","article-title":"[Remote cerebellar hemorrhage after lumbar spinal fluid drainage. 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