Relationship Between Cerebrospinal Fluid and Blood Dynamics in Healthy Volunteers and Patients with Communicating Hydrocephalus

Rationale and ObjectivesUsing magnetic resonance imaging (MRI), we investigated cerebral blood and cerebrospinal fluid (CSF) flows in patients with communicating hydrocephalus (CH) and in healthy volunteers to determine the contribution of CSF flow to brain pressure regulation in CH patients. MethodsCine phase-contrast MRI data from 16 healthy volunteers and 12 patients with CH characterized by hyperdynamic aqueductal CSF flow were analyzed using in-house image-processing software that automatically measured flow curves. Amplitude and temporal CSF and blood flow parameters were compared in the 2 groups. ResultsJugular peak flow occurred significantly earlier (P < 0.01) in the CH patients than in the healthy volunteers. Cervical CSF oscillations were not significantly different between the 2 groups. ConclusionVenous vessel compression and/or changes in intracranial subarachnoid CSF flow produce an increase in ventricular CSF flush that compensates for vascular brain expansion in patients with CH.

[1]  Andrew M. Blamire,et al.  Multi-modal MRI in normal pressure hydrocephalus identifies pre-operative haemodynamic and diffusion coefficient changes in normal appearing white matter correlating with surgical outcome , 2003, Clinical Neurology and Neurosurgery.

[2]  Sang Hoon Lee,et al.  PUBS: Pulsatility‐based segmentation of lumens conducting non‐steady flow , 2003, Magnetic resonance in medicine.

[3]  Hiroshi Fujita,et al.  Frequency analyses of CSF flow on cine MRI in normal pressure hydrocephalus , 2003, European Radiology.

[4]  M. Egnor,et al.  A Model of Pulsations in Communicating Hydrocephalus , 2002, Pediatric Neurosurgery.

[5]  I. Idy-Peretti,et al.  Cerebrospinal Fluid Dynamics and Relation with Blood Flow: A Magnetic Resonance Study with Semiautomated Cerebrospinal Fluid Segmentation , 2001, Investigative radiology.

[6]  P. Cornu,et al.  Cerebrospinal Fluid Flow Waveforms: MR Analysis in Chronic Adult Hydrocephalus , 2001, Investigative radiology.

[7]  G. Bateman.  Vascular compliance in normal pressure hydrocephalus. , 2000, AJNR. American journal of neuroradiology.

[8]  D N Levin,et al.  The mechanical state of intracranial tissues in elderly subjects studied by imaging CSF and brain pulsations. , 2000, Magnetic resonance imaging.

[9]  W. Bradley,et al.  Normal pressure hydrocephalus: new concepts on etiology and diagnosis. , 2000, AJNR. American journal of neuroradiology.

[10]  N. Fujita,et al.  Quantitation of flow in the superior sagittal sinus performed with cine phase-contrast MR imaging of healthy and achondroplastic children. , 2000, AJNR. American journal of neuroradiology.

[11]  K. Majamaa,et al.  Transient increase in procollagen propeptides in the CSF after subarachnoid hemorrhage , 2000, Neurology.

[12]  J Bittoun,et al.  Origin of subarachnoid cerebrospinal fluid pulsations: a phase-contrast MR analysis. , 2000, Magnetic resonance imaging.

[13]  Ryoong Huh,et al.  Quantitative assessment of cerebrospinal fluid hydrodynamics using a phase-contrast cine MR image in hydrocephalus , 1999, Child's Nervous System.

[14]  K. Ishii,et al.  CSF spaces in idiopathic normal pressure hydrocephalus: morphology and volumetry. , 1998, AJNR. American journal of neuroradiology.

[15]  D N Levin,et al.  Hemodynamically independent analysis of cerebrospinal fluid and brain motion observed with dynamic phase contrast MRI , 1996, Magnetic resonance in medicine.

[16]  W G Bradley,et al.  Normal-pressure hydrocephalus: evaluation with cerebrospinal fluid flow measurements at MR imaging. , 1996, Radiology.

[17]  J. Drake,et al.  Reduced Local Cerebral Blood Flow in Periventricular White Matter in Experimental Neonatal Hydrocephalus—Restoration with CSF Shunting , 1995, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[18]  F. Ståhlberg,et al.  The nocturnal increase in human cerebrospinal fluid production is inhibited by a beta 1-receptor antagonist. , 1994, The American journal of physiology.

[19]  D. Greitz,et al.  MR Imaging of Cerebrospinal Fluid Dynamics in Health and Disease , 1994, Acta radiologica.

[20]  C. Thomsen,et al.  Cerebrospinal fluid flow and production in patients with normal pressure hydrocephalus studied by MRI , 1994, Neuroradiology.

[21]  M Kouwenhoven,et al.  Phase-Contrast Cine Mr Imaging of Normal Aqueductal CSF Flow , 1994, Acta radiologica.

[22]  N J Pelc,et al.  Cerebrospinal fluid flow measured by phase-contrast cine MR. , 1993, AJNR. American journal of neuroradiology.

[23]  W G Bradley,et al.  Flow dynamics of cerebrospinal fluid: assessment with phase-contrast velocity MR imaging performed with retrospective cardiac gating. , 1992, Radiology.

[24]  C Thomsen,et al.  Fourier analysis of cerebrospinal fluid flow velocities: MR imaging study. The Scandinavian Flow Group. , 1990, Radiology.

[25]  H. Nagai,et al.  MR imaging of CSF pulsatory flow and its relation to intracranial pressure. , 1988, Journal of neurosurgery.

[26]  J. Miller,et al.  Spectral analysis of the CSF pulse wave at different locations in the craniospinal axis. , 1986, Journal of neurology, neurosurgery, and psychiatry.

[27]  W. Bradley,et al.  Flowing cerebrospinal fluid in normal and hydrocephalic states: appearance on MR images. , 1986, Radiology.

[28]  J. D. Burton,et al.  The physics of the cranial cavity, hydrocephalus and normal pressure hydrocephalus: mechanical interpretation and mathematical model. , 1976, Surgical neurology.

[29]  R. Wilson,et al.  Corticosteroid therapy of experimental hydrocephalus after intraventricular-subarachnoid haemorrhage , 1974, Journal of neurology, neurosurgery, and psychiatry.

[30]  R. D. Adams,et al.  The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. Observations on cerebrospinal fluid hydrodynamics. , 1965, Journal of the neurological sciences.

[31]  J. Vanneste,et al.  Diagnosis and management of normal-pressure hydrocephalus , 2000, Journal of Neurology.

[32]  M. Mase,et al.  Quantitative analysis of CSF flow dynamics using MRI in normal pressure hydrocephalus. , 1998, Acta neurochirurgica. Supplement.

[33]  D. Fletcher,et al.  Fluid dynamics of the cerebral aqueduct. , 1996, Pediatric neurosurgery.

[34]  D. Greitz,et al.  Restricted arterial expansion as a universal causative factor in communicating hydrocephalus , 1995 .

[35]  G. Zannoli,et al.  Temporal and spatial assessment of normal cerebrospinal fluid dynamics with MR imaging. , 1993, Magnetic resonance imaging.

[36]  P. McHugh.  OCCULT HYDROCEPHALUS. , 1964, The Quarterly journal of medicine.