Flowing Cerebrospinal Fluid in Normal and Hydrocephalic States: Appearance on MR images

Bradley, William G.; Kortman, Keith E.; Burgoyne, Brian

doi:10.1007/978-3-662-11149-9_38

Cited by 46 publications

(73 citation statements)

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“…In other words, considering the fact that CSF flow is not bulk flow but pulsatile flow, the energy contained within the CSF is substantial. Moreover, in many previous studies, investigations utilizing flow sensitive MRI have revealed that pulsatile CSF flow is significantly higher in the aqueduct in communicating hydrocephalus conditions [15][16][17]. This observation partly supports our theory that defective energy transfer and dissipation leads to high CSF pulsation energy in communicating hydrocephalus to cause lateral ventricle dilatation.…”

supporting

confidence: 88%

Hypothesis for lateral ventricular dilatation in communicating hydrocephalus: New understanding of the Monro-Kellie hypothesis in the aspect of cardiac energy transfer through arterial blood flow

Lee

Yoon

2009

Medical Hypotheses

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supporting

confidence: 88%

Hypothesis for lateral ventricular dilatation in communicating hydrocephalus: New understanding of the Monro-Kellie hypothesis in the aspect of cardiac energy transfer through arterial blood flow

Lee

Yoon

2009

Medical Hypotheses

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“…This outflow results in a normal MR imaging CSF flow void in the aqueduct. 4 The systolic expansion forces CSF and venous blood out of the fixed volume of the skull by the Monro-Kellie hypothesis. 5 This process results in the systolic outflow of CSF at the foramen magnum and from there down the SAS of the spinal canal.…”

Section: Normal Macroscopic Csf Flowmentioning

confidence: 99%

CSF Flow in the Brain in the Context of Normal Pressure Hydrocephalus

Bradley

2014

AJNR Am J Neuroradiol

148

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SUMMARY: CSF normally flows back and forth through the aqueduct during the cardiac cycle. During systole, the brain and intracranial vasculature expand and compress the lateral and third ventricles, forcing CSF craniocaudad. During diastole, they contract and flow through the aqueduct reverses. Hyperdynamic CSF flow through the aqueduct is seen when there is ventricular enlargement without cerebral atrophy. Therefore, patients presenting with clinical normal pressure hydrocephalus who have hyperdynamic CSF flow have been found to respond better to ventriculoperitoneal shunting than those with normal or decreased CSF flow. Patients with normal pressure hydrocephalus have also been found to have larger intracranial volumes than sex-matched controls, suggesting that they may have had benign external hydrocephalus as infants. While their arachnoidal granulations clearly have decreased CSF resorptive capacity, it now appears that this is fixed and that the arachnoidal granulations are not merely immature. Such patients appear to develop a parallel pathway for CSF to exit the ventricles through the extracellular space of the brain and the venous side of the glymphatic system. This pathway remains functional until late adulthood when the patient develops deep white matter ischemia, which is characterized histologically by myelin pallor (ie, loss of lipid). The attraction between the bare myelin protein and the CSF increases resistance to the extracellular outflow of CSF, causing it to back up, resulting in hydrocephalus. Thus idiopathic normal pressure hydrocephalus appears to be a "2 hit" disease: benign external hydrocephalus in infancy followed by deep white matter ischemia in late adulthood. ABBREVIATIONS:ACSV ϭ aqueductal CSF stroke volume; DESH ϭ disproportionately enlarged subarachnoid space hydrocephalus; DWMI ϭ deep white matter

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“…There is an expansion of the brain caused by arterial blood inflow during systole and relaxation of the brain caused by blood outflow during diastole. 10,24,49 These pulsatile changes in intracranial arterial blood volume shift the CSF. 19 Furthermore, brain parenchyma motion contributes to CSF flow.…”

Section: Discussionmentioning

confidence: 99%

Analysis of aqueductal cerebrospinal fluid flow after endoscopic aqueductoplasty by using cine phase-contrast magnetic resonance imaging

Schroeder¹,

Schweim²,

Schweim³

et al. 2000

FOC

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Object The purpose of this prospective study was to evaluate aqueductal cerebrospinal fluid (CSF) flow after endoscopic aqueductoplasty. In all patients, preoperative magnetic resonance (MR) imaging revealed hydrocephalus caused by aqueductal stenosis and lack of aqueductal CSF flow. Methods In 14 healthy volunteers and in eight patients with aqueductal stenosis who had undergone endoscopic aqueductoplasty, aqueductal CSF flow was investigated using cine cardiac-gated phase-contrast MR imaging. For qualitative evaluation of CSF flow, the authors used an in-plane phase-contrast sequence in the midsagittal plane. The MR images were displayed in a closed-loop cine format. Quantitative through-plane measurements were performed in the axial plane perpendicular to the aqueduct. Evaluation revealed no significant difference in aqueductal CSF flow between healthy volunteers and patients with regard to temporal parameters, CSF peak and mean velocities, mean flow, and stroke volume. All restored aqueducts have remained patent 7 to 31 months after surgery. Conclusions Aqueductal CSF flow after endoscopic aqueductoplasty is similar to aqueductal CSF flow in healthy volunteers. The data indicate that endoscopic aqueductoplasty seems to restore physiological aqueductal CSF flow.

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Flowing Cerebrospinal Fluid in Normal and Hydrocephalic States: Appearance on MR images

Cited by 46 publications

References 0 publications

Hypothesis for lateral ventricular dilatation in communicating hydrocephalus: New understanding of the Monro-Kellie hypothesis in the aspect of cardiac energy transfer through arterial blood flow

Hypothesis for lateral ventricular dilatation in communicating hydrocephalus: New understanding of the Monro-Kellie hypothesis in the aspect of cardiac energy transfer through arterial blood flow

CSF Flow in the Brain in the Context of Normal Pressure Hydrocephalus

Analysis of aqueductal cerebrospinal fluid flow after endoscopic aqueductoplasty by using cine phase-contrast magnetic resonance imaging

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