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Velocity and pressure gradients of cerebrospinal fluid assessed with magnetic resonance imaging.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Matsumae, Mitsunori Hirayama, Akihiro Atsumi, Hideki Yatsushiro, Satoshi Kuroda, Kagayaki
Description	Author Affiliation: Matsumae M ( Department of Neurosurgery, Tokai University School of Medicine, Isehara, Kanagawa)
Abstract	OBJECT: New approaches for understanding CSF motion in healthy individuals and patients with hydrocephalus and Chiari malformation are presented. The velocity and the pressure gradient of CSF motion were determined using phase contrast (PC) MRI. METHODS: The authors examined 11 healthy control subjects and 2 patients (1 with hydrocephalus and 1 with Chiari malformation), using 4-dimensional PC (4D-PC) MRI and a newly developed computer analysis method that includes calculation of the pressure gradient from the velocity field. Sagittal slices including the center of the skull and coronal slices of the foramen of Monro and the third ventricle were used. RESULTS: In the ventricular system, mixing and swirling of the CSF was observed in the third ventricle. The velocity images showed that the CSF was pushed up and back down to the adjacent ventricle and then returned again to the third ventricle. The CSF traveled bidirectionally in the foramen of Monro and sylvian aqueduct. Around the choroid plexus in the lateral ventricle, the CSF motion was stagnant and the CSF pressure gradient was lower than at the other locations. An elevated pressure gradient was observed in the basal cistern of the subarachnoid space. Sagittal imaging showed that the more prominent pressure gradients originated around the cisterna magna and were transmitted in an upward direction. The coronal image showed a pressure gradient traveling from the central to the peripheral subarachnoid spaces that diminished markedly in the convexity of the cerebrum. The 2 patients, 1 with secondary hydrocephalus and 1 with Chiari malformation, were also examined. CONCLUSIONS: The observed velocity and pressure gradient fields delineated the characteristics of the CSF motion and its similarities and differences among the healthy individuals and between them and the 2 patients. Although the present results did not provide general knowledge of CSF motion, the authors' method more comprehensively described the physiological properties of the CSF in the skull than conventional approaches that do not include measurements of pressure gradient fields.
File Format	HTM / HTML
ISSN	00223085
e-ISSN	19330693
Journal	Journal of Neurosurgery
Issue Number	1
Volume Number	120
Language	English
Publisher	American Association of Neurological Surgeons
Publisher Date	2014-01-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Neurosurgery Arnold-chiari Malformation Cerebrospinal Fluid Cerebral Ventricles Pathology Cerebrospinal Fluid Pressure Hydrocephalus Adolescent Choroid Plexus Magnetic Resonance Imaging Subarachnoid Space Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Neurology (clinical) Surgery

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