Fluid Outflow in a Large-Animal Model of Posttraumatic Syringomyelia

Wong, Johnny; Hemley, Sarah J.; Jones, Nigel R.; Bilston, Lynne E.; Stoodley, Marcus A.

doi:10.1227/neu.0b013e31825927d6

Cited by 11 publications

(15 citation statements)

References 54 publications

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“…In fact, CSF flowed preferentially into the syrinx, ahead of perivascular flow into the rostral portions of the SC (Brodbelt et al, 2003a). A more recent animal study from the same group demonstrated extra-canalicular syrinx fluid egress by tracking HRP reaction product in adjacent grey and white matter and around the central canal and perivascular spaces (Wong et al, 2012).…”

Section: Where Does Syrinx Fluid Originate?mentioning

confidence: 94%

“…The ISF and nerve cells form a poroelastic material 3 . Tracer studies in animals indicate that the grey and white matter permit bulk ISF flow (e.g., Wong et al, 2012), which may be anisotropic (Saadoun and Papadopoulos, 2010). However, the dominant mechanism by which excess fluid is eliminated from the cord remains obscure.…”

Section: Materials Propertiesmentioning

confidence: 99%

“…In the brain this fluid is evacuated into the subarachnoid and ventricular CSF, the latter involving passage through gaps between the ependymal cells that line the ventricles (Johanson, 2008;Saadoun and Papadopoulos, 2010). There is a dearth of evidence on the porosity of the CC ependyma (Wong et al, 2012).…”

Section: Cerebrospinal Blood Supply and Csf Interactionsmentioning

confidence: 99%

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Syringomyelia: A review of the biomechanics

Elliott

Bertram

Martin

et al. 2013

Journal of Fluids and Structures

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Syringomyelia is a neurological disorder caused by the development of one or more macroscopic fluid-filled cavities in the spinal cord. While the aetiology remains uncertain, hydrodynamics appear to play a role. This has led to the involvement of engineers, who have modelled the system in silico and on the bench. In the process, hypotheses from the neurosurgical literature have been tested, and others generated, while aspects of the system mechanics have been clarified. The spinal cord is surrounded by cerebrospinal fluid (CSF) which is subject both to the periodic excitation of CSF expelled from the head with each heartbeat, and to intermittent larger transients from cough, sneeze, etc., via vertebral veins. The resulting pulsatile flow and pressure wave propagation, and their possible effects on cord cavities and cord stresses, have been elucidated. These engineering contributions are here reviewed for the first time.

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Section: Where Does Syrinx Fluid Originate?mentioning

confidence: 94%

Section: Materials Propertiesmentioning

confidence: 99%

Section: Cerebrospinal Blood Supply and Csf Interactionsmentioning

confidence: 99%

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Syringomyelia: A review of the biomechanics

Elliott

Bertram

Martin

et al. 2013

Journal of Fluids and Structures

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“…The use of sheep is appropriate because much is known of its CSF physiology [7-10] . Additionally, kaolin has been used to induce hydrocephalus in fetal sheep [11,12] and has also been used to create syringomyelia in adult sheep [13]. As part of this study, the relationship between shunt success/failure with the clinical status was assessed.…”

Section: Introductionmentioning

confidence: 99%

Pre- and post-shunting observations in adult sheep with kaolin-induced hydrocephalus

Johnston

Bigio

Drake

et al. 2013

Fluids Barriers CNS

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BackgroundThe objective of this study was to examine host-shunt interactions in sheep with kaolin-induced hydrocephalus.MethodsForty-two sheep (29–40 kg) were utilized for this study. In 20 animals, various kaolin doses were injected into the cisterna magna including 10 and 50 mg/kg as well as 2–4 ml of a 25% kaolin suspension. Based on animal health and hydrocephalus development, 3 ml of a 25% kaolin suspension was chosen. In 16 animals, kaolin was administered and 6–8 days later, the animals received a custom made ventriculo-peritoneal shunt. In 8 animals ventricular CSF pressures were measured with a water manometer before kaolin administration and 7–8 days later. The sheep were allowed to survive for up to 9–12 weeks post-kaolin or until clinical status required euthanasia. Brains were assessed for morphological and histological changes. Ventricle/cerebrum cross sectional area ratios (V/C) were calculated from photographs of the sliced coronal planes immediately anterior to the interventricular foramina.ResultsIntraventricular pressures increased from 12.4±1.1 cm H2O to 41.3±3.5 cm H2O following kaolin injection (p < 0.0001, n = 8). In all animals, we observed kaolin on the basal surface of the brain and mild (V/C 0.03-0.10) to moderate (V/C >0.10) ventricular expansion. The animals lost weight between kaolin administration and shunting (33.7±1.2 kg versus 31.0±1.7 kg) with weights after shunting remaining stable up to sacrifice (31.6±2.2 kg). Of 16 shunted animals, 5 did well and were sacrificed 9–12 weeks post-kaolin. In the remainder, the study was terminated at various times due to deteriorating health. Hydrocephalus was associated with thinning of the corpus callosum, but no obvious loss of myelin staining, along with reactive astroglial (glial fibrillary acidic immunoreactive) and microglial (Iba1 immunoreactive) changes in the white matter. Ventricular shunts revealed choroid plexus ingrowth in 5/16, brain tissue ingrowth in 1/16, problems with shunt insertion in 3/16, occlusion by hemorrhagic-inflammatory material in 5/16, or no obstruction in 2/16. Free flowing CSF indicated that the peritoneal catheter was patent.ConclusionsCerebrospinal fluid shunts in hydrocephalic sheep fail in ways that are reminiscent of human neurosurgical experience suggesting that this model may be helpful in the development of more effective shunt technology.

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“…McLaurin and associates firstly described using kaolin injection into the cisterna magna consistently resulted in the development of chronic obstructive hydrocephalus in experimental animals 21 . Then a series of experimental SM models induced by kaolin injection into spinal cord and subarachnoid space have been reported [22][23][24][25][26][27][28][29] . Inflammatory…”

Section: Discussionmentioning

confidence: 99%

Continuous Hypodynamic Change of Cerebrospinal Fluid Flow as A Potential Factor Working for Experimental Scoliotic Formation

Zhao

et al. 2020

Sci Rep

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Scoliosis is often associated with syringomyelia (SM). As an important role in SM formation, the influence from abnormal cerebrospinal fluid (CSF) flow is still unclear to scoliosis. The aim of this experimental work is to explore the connection between CSF flow and scoliosis through imaging and histological analysis on the basis of a kaolin-induced scoliotic rabbit model. For imaging observation, in 40 kaolin-induced rabbits by C7 spinal cord injection, through pre-and postoperative MRI and radiography, CSF flow and scoliosis formation were detected at consecutive phases. According to the final formation of scoliosis until postoperative week 12, the kaolin-induced rabbits were divided into 2 groups. Through comparing the 2 groups, the relationship between the changes of CSF flow velocity and scoliosis formation were reviewed and analyzed. For histological observation, another 20 kaolininduced rabbits were used for consecutive histological observations of spinal cord at postoperative 3-day, 2-week, 4-week and 6-week. After kaolin-induction, abnormal spinal coronal curve was observed from postoperative week 6 in the 37 survived rabbits. At postoperative week 12, scoliosis formation was detected in 73.0% kaolin-induced rabbits and the mean Cobb angle was 27.4°. From the comparison between scoliotic and non-scoliotic groups, the difference of the velocities of CSF flow was more obviously from postoperative week 4 to 12, especially after week 6. In the scoliotic group, the peak velocity of CSF flow was diseased gradually following scoliosis formation after induction. Moreover, the decrease of the peak velocities of CSF flow from preoperation to postoperative 12 weeks (ΔVmax), including up-flow (ΔVUmax) and down-flow (ΔVDmax), were positively correlated to the final scoliotic cobb angle (P < 0.01). Through histological observation at different phases, the distinctive pathological changes of the spinal cord included early inflammatory reaction, adhesion and blockage in the subarachnoid space and the central canal, perivascular space enlargement, central canal expansion, which suggested the CSF flow being blocked by multiple ways after kaolin-induction. In conclusion, experimental scoliosis can be successfully induced by intraspinal kaolin injection. In this model, continuous hypodynamic change of CSF flow was correlated to the formation of scoliosis, which could be an important factor of scoliotic pathogenesis being explored furtherly.Scoliosis is often associated with syringomyelia (SM) in clinical, which can be found in 25-85% of the patients being diagnosed as SM 1 . Meanwhile, SM also can be detected by magnetic resonance imaging (MRI) in 19.5% infantile, 26% juvenile and 20% adolescent patients ever being diagnosed as idiopathic scoliosis (IS) 2 . Moreover, in the patients with severe scoliosis (Cobb angle more than 90°), the rate of associated-SM is even up to 60.4% 3 . However, the relationship between scoliosis and SM is still obscure, which has been explained as a causal link through the "paraspinal muscle den...

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Fluid Outflow in a Large-Animal Model of Posttraumatic Syringomyelia

Cited by 11 publications

References 54 publications

Syringomyelia: A review of the biomechanics

Syringomyelia: A review of the biomechanics

Pre- and post-shunting observations in adult sheep with kaolin-induced hydrocephalus

Continuous Hypodynamic Change of Cerebrospinal Fluid Flow as A Potential Factor Working for Experimental Scoliotic Formation

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