| Autor: |
Vinje V; Department of Scientific Computing and Numerical Analysis, Simula Research Laboratory, 1325, Lysaker, Norway. vegard@simula.no., Ringstad G; Department of Radiology and Nuclear Medicine, Oslo University Hospital - Rikshospitalet, 0372, Oslo, Norway., Lindstrøm EK; Department of Mathematics, University of Oslo, 0315, Oslo, Norway., Valnes LM; Department of Mathematics, University of Oslo, 0315, Oslo, Norway., Rognes ME; Department of Scientific Computing and Numerical Analysis, Simula Research Laboratory, 1325, Lysaker, Norway., Eide PK; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0315, Oslo, Norway.; Department of Neurosurgery, Oslo University Hospital - Rikshospitalet, 0372, Oslo, Norway., Mardal KA; Department of Scientific Computing and Numerical Analysis, Simula Research Laboratory, 1325, Lysaker, Norway.; Department of Mathematics, University of Oslo, 0315, Oslo, Norway. |
| Abstrakt: |
Current theories suggest that waste solutes are cleared from the brain via cerebrospinal fluid (CSF) flow, driven by pressure pulsations of possibly both cardiac and respiratory origin. In this study, we explored the importance of respiratory versus cardiac pressure gradients for CSF flow within one of the main conduits of the brain, the cerebral aqueduct. We obtained overnight intracranial pressure measurements from two different locations in 10 idiopathic normal pressure hydrocephalus (iNPH) patients. The resulting pressure gradients were analyzed with respect to cardiac and respiratory frequencies and amplitudes (182,000 cardiac and 48,000 respiratory cycles). Pressure gradients were used to compute CSF flow in simplified and patient-specific models of the aqueduct. The average ratio between cardiac over respiratory flow volume was 0.21 ± 0.09, even though the corresponding ratio between the pressure gradient amplitudes was 2.85 ± 1.06. The cardiac cycle was 0.25 ± 0.04 times the length of the respiratory cycle, allowing the respiratory pressure gradient to build considerable momentum despite its small magnitude. No significant differences in pressure gradient pulsations were found in the sleeping versus awake state. Pressure gradients underlying CSF flow in the cerebral aqueduct are dominated by cardiac pulsations, but induce CSF flow volumes dominated by respiration. |
