Effects of the Valsalva maneuver on pial artery pulsation and subarachnoid width in healthy adults

► The Valsalva maneuver evokes significant changes in pial artery pulsation. ► Phases IIa and III of Valsalva maneuver are hazardous for brain microcirculation. ► Changes in pial artery pulsation precede changes in cerebral blood flow. ► There are direct interactions between pial arteries and the cerebrospinal fluid compartment. ► NIR-T/BSS allows for non-invasive monitoring of the pial artery pulsation and width of the subarachnoid space.