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Original research
Effect of a neck collar on brain turgor: a potential role in preventing concussions?
  1. Michael Dinsmore1,
  2. Zakir Hajat2,
  3. Connor TA Brenna3,
  4. Joseph Fisher1,
  5. Lashmi Venkatraghavan1
  1. 1Department of Anaesthesia and Pain Medicine, Toronto Western Hospital, Toronto, Ontario, Canada
  2. 2Department of Anaesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada
  3. 3Department of Anaesthesia and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Michael Dinsmore, Department of Anaesthesia and Pain Medicine, Toronto Western Hospital, Toronto, ON M5T 2S8, Canada; michael.dinsmore{at}uhn.ca

Abstract

Background Mild internal jugular vein (IJV) compression, aimed at increasing intracranial fluid volume to prevent motion of the brain relative to the skull, has reduced brain injury markers in athletes suffering repeated traumatic brain injuries. However, an increase in intracranial volume with IJV compression has not been well demonstrated. This study used transorbital ultrasound to identify changes in optic nerve sheath diameter (ONSD) as a direct marker of accompanying changes in intracranial volume.

Methods Nineteen young, healthy adult volunteers (13 males and 6 females) underwent IJV compression of 20 cm H2O low in the neck, while in upright posture. IJV cross-sectional area at the level of the cricoid cartilage, and the change in right ONSD 3 mm behind the papillary segment of the optic nerve, were measured by ultrasound. Statistical analysis was performed using a paired t-test with Bonferroni correction.

Results Mean (SD) cross-sectional area for the right IJV before and after IJV compression was 0.10 (0.05) cm2 and 0.57 (0.37) cm2, respectively (p=0.001). ONSD before and after IJV compression was 4.6 (0.5) mm and 4.9 (0.5) mm, respectively (p=0.001).

Conclusions These data verify increased cerebral volume following IJV compression, supporting the potential for reduced brain ‘slosh’ as a mechanism connecting IJV compression to possibly reducing traumatic brain injury following head trauma.

  • brain concussion

Data availability statement

Data are available on reasonable request. Data are available on reasonable request. Please contact corresponding author: 0000-0002-9304-0751.

https://doi.org/10.1136/bjsports-2021-103961

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    Data availability statement

    Data are available on reasonable request. Data are available on reasonable request. Please contact corresponding author: 0000-0002-9304-0751.

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    Footnotes

    • Contributors MD contributed to the experimental design, data acquisition, analysis, manuscript and is responsible for the overall content as the guarantor. ZH contributed to data acquisition and analysis and manuscript. CTAB helped with drafting of manuscript and editing. JF contributed to experimental design and manuscript. LV contributed to experimental design and manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.