MR Imaging and Quantification of the Movement of the Lamina Terminalis Depending on the CSF Dynamics

Reubelt, D; Small, LF; Hoffmann, Martin; Kapapa, Thomas; Schmitz, Bernd

doi:10.3174/ajnr.a1306

Cited by 17 publications

(15 citation statements)

References 10 publications

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“…[21][22][23] PVI CC together with ⌬V CC determines the impact on the brain caused by the arterial pulsations (approximately 30 million each year). With increasing age, arterial physiology changes.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Craniospinal Pressure-Volume Indices

Wåhlin¹,

Ambarki²,

Birgander³

et al. 2010

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The PVI CC of the craniospinal compartment defines the shape of the pressure-volume curve and determines the damping of cyclic arterial pulsations. Despite no reports of direct measurements of the PVI CC among healthy elderly, it is believed that a change away from adequate accommodation of cardiac-related pulsations may be a pathophysiologic mechanism seen in neurodegenerative disorders such as Alzheimer disease and idiopathic normal pressure hydrocephalus. In this study, blood and CSF flow measurements are combined with lumbar CSF infusion measurements to assess the craniospinal PVI CC and its distribution of cranial and spinal compartments in healthy elderly.

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Section: Discussionmentioning

confidence: 99%

Assessment of Craniospinal Pressure-Volume Indices

Wåhlin¹,

Ambarki²,

Birgander³

et al. 2010

AJNR Am J Neuroradiol

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“…39 Cine bFFE is suitable for neuroimaging, 36,45,55 and specific applications to that manual measurement of cerebellar tonsillar motion demonstrated substantial to near-perfect reliability. 48 Driver et al 16 assessed cerebellar motion using cine bFFE in a related canine condition, Chiari-like malformation (CLM).…”

mentioning

confidence: 99%

Cerebellar and hindbrain motion in Chiari malformation with and without syringomyelia

Leung

Magnussen

Stoodley

et al. 2016

SPI

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OBJECTIVE The pathogenesis of syringomyelia associated with Chiari malformation type I (CM-I) is unclear. Theories of pathogenesis suggest the cerebellar tonsils may obstruct CSF flow or alter pressure gradients, or their motion might act as a piston to increase CSF pressure in the spinal subarachnoid space. This study was performed to measure cerebellar tonsillar and hindbrain motion in CM-I and assess the potential contributions to syrinx formation. METHODS Sixty-four CM-I patients and 25 controls were retrospectively selected from a clinical database, and all subjects had undergone cardiac-gated cine balanced fast-field echo MRI. There were a total of 36 preoperative CM-I scans, which consisted of 15 patients with and 21 patients without syringomyelia. Nineteen patients underwent paired pre- and postoperative imaging. Anteroposterior (AP) and superoinferior (SI) movements of the tip of the cerebellar tonsils, obex, fastigium of the fourth ventricle, pontomedullary junction, and cervicomedullary junction were measured. The distance between the fastigium and tip of the tonsils was used to calculate tonsillar tissue strain (Δi/i0). RESULTS CM-I patients had significantly greater cerebellar tonsillar motion in both the AP and SI directions than controls (AP +0.34 mm [+136%], p < 0.001; SI +0.49 mm [+163%], p < 0.001). This motion decreased after posterior fossa decompression (AP −0.20 mm [−33%], p = 0.001; SI −0.29 mm [−36%]; p < 0.001), but remained elevated above control levels (AP +56%, p = 0.021; SI +67%, p = 0.015). Similar trends were seen for all other tracked landmarks. There were no significant differences in the magnitude or timing of motion throughout the hindbrain between CM-I patients with and without syringomyelia. Increased tonsillar tissue strain correlated with Valsalva headaches (p = 0.03). CONCLUSIONS Cerebellar tonsillar motion may be a potential marker of CM-I and may have use in tailoring surgical procedures. The lack of association with syringomyelia suggests that tonsillar motion alone is not the driver of syrinx formation. Tonsillar tissue strain may play a part in the pathophysiology of Valsalva headaches.

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“…5 With the advent of MR imaging and quantification of spinal CSF pulsations, 11 the noninvasive analysis of CSF hydrodynamics became possible. 13 MR imaging studies have measured the pulsatile motion of the cerebellar tonsils 14 and lamina terminalis 15 and have documented sinusoidal CSF flow linked to the cardiac cycle within syringes, along the spinal subarachnoid space, and across the foramen magnum. 16,17 Most studies have used phase contrast techniques, which have allowed quantification of CSF velocities but with reduced anatomic resolution.…”

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confidence: 99%

Syringomyelia Fluid Dynamics and Cord Motion Revealed by Serendipitous Null Point Artifacts during Cine MRI

Honey

Martin

Heran

2017

AJNR Am J Neuroradiol

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SUMMARY: Dynamic MR imaging was used to evaluate a cervical syrinx in an adolescent boy with an associated hindbrain herniation. Null artifacts were present on one of the sequences that allowed simultaneous high-resolution visualization of syrinx fluid motion and the anatomy of the syrinx walls. A brief review of the theories of syrinx formation and propagation is provided with a comment on why the Williams "slosh" theory of syrinx progression is supported by our unique imaging.

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MR Imaging and Quantification of the Movement of the Lamina Terminalis Depending on the CSF Dynamics

Cited by 17 publications

References 10 publications

Assessment of Craniospinal Pressure-Volume Indices

Assessment of Craniospinal Pressure-Volume Indices

Cerebellar and hindbrain motion in Chiari malformation with and without syringomyelia

Syringomyelia Fluid Dynamics and Cord Motion Revealed by Serendipitous Null Point Artifacts during Cine MRI

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