Simulating CSF Flow Dynamics in the Normal and the Chiari I Subarachnoid Space during Rest and Exertion

Linge, Svein; Mardal, Kent‐André; Haughton, Victor M.; Helgeland, Anders

doi:10.3174/ajnr.a3282

Cited by 19 publications

(15 citation statements)

References 11 publications

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“…The maximum systolic and diastolic velocities of CM-I patients were 5.25 ± 1.1 and 4.97 ± 1.1 (cm/s), respectively (Table 1). These values completely conform to studies by Linge et al 54,73 . According to the studies by Linge et al, maximum Reynolds numbers were lower than 780 for CM-I patients 72 , which are close to the results of the present study ( Table 1).…”

Section: Discussionsupporting

confidence: 92%

“…Therefore, these results, similar to the evaluation results of the correlation between the maximum CSF pressure and the volumetric parameters, showed that PCF volume was a more accurate and relevant volumetric parameter for assessing the conditions of these patients. The deformable boundaries between CSF and the spinal subarachnoid space were neglected during the present biomechanical simulation as similar to the previous studies 21,43,45,46,[53][54][55][56]72,73,85 . However, according to recent findings of Tangen et al 70 , simulations using moving boundary might alter the observed maximum CSF pressure.…”

Section: Discussionmentioning

confidence: 89%

“…However, this deformation was neglected in the majority of previous studies assessing CSF hydrodynamics in CM-I patients. They chose no-slip boundary conditions at the spinal cord and dural boundaries, and used the CFD solution method for simulations 21,43,45,46,[53][54][55][56]72,73 . Therefore, according to the main focus of the present study and based on the results of previous studies, the spinal subarachnoid space is defined as a non-deformable boundary and CSF is considered as an incompressible Newtonian fluid 21,46,54,55,72,73 for the CFD simulation of CSF hydrodynamics in normal subjects and patients.…”

Section: Methodsmentioning

confidence: 99%

“…However, PC-MRI has limitations in measuring velocity distribution at all locations and under all conditions of patients, and further, it cannot measure CSF pressure 51,52 . Hence, CSF hydrodynamic parameters have been calculated in many studies non-invasively using computational fluid dynamic (CFD) simulation and have been used as an index for assessing conditions and surgical outcomes of CM-I patients 21,[53][54][55][56][57][58] . Despite numerous studies performed for assessing hydrodynamic parameters affecting CM-I, many studies still doubt the role of CSF hydrodynamics in the pathophysiology of CM-I patients 53,59 , and thus, are uncertain about the significance of hydrodynamic parameters.…”

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confidence: 99%

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Correlation of a new hydrodynamic index with other effective indexes in Chiari I malformation patients with different associations

Gholampour

2020

Sci Rep

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This study aimed to find a new CSF hydrodynamic index to assess Chiari type I malformation (CM-I) patients’ conditions and examine the relationship of this new index with morphometric and volumetric changes in these patients and their clinical symptoms. To this end, 58 CM-I patients in four groups and 20 healthy subjects underwent PC-MRI. Ten morphometric and three volumetric parameters were calculated. The CSF hydrodynamic parameters were also analyzed through computational fluid dynamic (CFD) simulation. The maximum CSF pressure was identified as a new hydrodynamic parameter to assess the CM-I patients’ conditions. This parameter was similar in patients with the same symptoms regardless of the group to which they belonged. The result showed a weak correlation between the maximum CSF pressure and the morphometric parameters in the patients. Among the volumetric parameters, PCF volume had the highest correlation with the maximum CSF pressure, which its value being higher in patients with CM-I/SM/scoliosis (R2 = 65.6%, P = 0.0022) than in the other patients. PCF volume was the more relevant volumetric parameter to assess the patients’ symptoms. The values of PCF volume were greater in patients that headache symptom was more obvious than other symptoms, as compared to the other patients.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 89%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Correlation of a new hydrodynamic index with other effective indexes in Chiari I malformation patients with different associations

Gholampour

2020

Sci Rep

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“…Computational fluid dynamics (CFD) provides both pressure and velocity parameters with high temporal and spatial resolution, and has consequently become a popular tool for simulating the flow changes caused by the Chiari I malformation [ 5 – 9 ]. Both patient specific and idealized geometries have been used in CFD studies.…”

Section: Introductionmentioning

confidence: 99%

Computational Investigation of Cerebrospinal Fluid Dynamics in the Posterior Cranial Fossa and Cervical Subarachnoid Space in Patients with Chiari I Malformation

et al. 2016

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PurposePrevious computational fluid dynamics (CFD) studies have demonstrated that the Chiari malformation is associated with abnormal cerebrospinal fluid (CSF) flow in the cervical part of the subarachnoid space (SAS), but the flow in the SAS of the posterior cranial fossa has received little attention. This study extends previous modelling efforts by including the cerebellomedullary cistern, pontine cistern, and 4th ventricle in addition to the cervical subarachnoid space.MethodsThe study included one healthy control, Con1, and two patients with Chiari I malformation, P1 and P2. Meshes were constructed by segmenting images obtained from T2-weighted turbo spin-echo sequences. CFD simulations were performed with a previously verified and validated code. Patient-specific flow conditions in the aqueduct and the cervical SAS were used. Two patients with the Chiari malformation and one control were modelled.ResultsThe results demonstrated increased maximal flow velocities in the Chiari patients, ranging from factor 5 in P1 to 14.8 in P2, when compared to Con1 at the level of Foramen Magnum (FM). Maximal velocities in the cervical SAS varied by a factor 2.3, while the maximal flow in the aqueduct varied by a factor 3.5. The pressure drop from the pontine cistern to the cervical SAS was similar in Con1 and P1, but a factor two higher in P2. The pressure drop between the aqueduct and the cervical SAS varied by a factor 9.4 where P1 was the one with the lowest pressure jump and P2 and Con1 differed only by a factor 1.6.ConclusionThis pilot study demonstrates that including the posterior cranial fossa is feasible and suggests that previously found flow differences between Chiari I patients and healthy individuals in the cervical SAS may be present also in the SAS of the posterior cranial fossa.

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Direct numerical simulation of transitional hydrodynamics of the cerebrospinal fluid in Chiari I malformation: The role of cranio‐vertebral junction

Jain

Ringstad

Eide

et al. 2017

Numer Methods Biomed Eng

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Obstruction to the cerebrospinal fluid (CSF) outflow caused by the herniation of cerebellar tonsils as a result of Chiari malformation type I leads to altered CSF hydrodynamics. This contribution explores the minutest characteristics of the CSF hydrodynamics in cervical subarachnoid space (SAS) of a healthy subject and 2 Chiari patients by performing highly resolved direct numerical simulation. The lattice Boltzmann method is used for the simulations because of its scalability on modern supercomputers that allow us to simulate up to approximately 10 cells while resolving the Kolmogorov microscales. The results depict that whereas the complex CSF flow remains largely laminar in the SAS of a healthy subject, constriction of the cranio-vertebral junction in Chiari I patients causes manifold fluctuations in the hydrodynamics of the CSF. These fluctuations resemble a flow that is in a transitional regime rather than laminar or fully developed turbulence. The fluctuations confine near the cranio-vertebral junction and are triggered due to the tonsillar herniation, which perturbs the flow as a result of altered anatomy of the SAS.

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Simulating CSF Flow Dynamics in the Normal and the Chiari I Subarachnoid Space during Rest and Exertion

Cited by 19 publications

References 11 publications

Correlation of a new hydrodynamic index with other effective indexes in Chiari I malformation patients with different associations

Correlation of a new hydrodynamic index with other effective indexes in Chiari I malformation patients with different associations

Computational Investigation of Cerebrospinal Fluid Dynamics in the Posterior Cranial Fossa and Cervical Subarachnoid Space in Patients with Chiari I Malformation

Direct numerical simulation of transitional hydrodynamics of the cerebrospinal fluid in Chiari I malformation: The role of cranio‐vertebral junction

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