TY - JOUR
T1 - Assessment of cerebrospinal fluid outflow resistance
AU - Eklund, Anders
AU - Smielewski, Peter
AU - Chambers, Iain
AU - Alperin, Noam
AU - Malm, Jan
AU - Czosnyka, Marek
AU - Marmarou, Anthony
N1 - Funding Information:
Acknowledgments We thank Nina Andersson for assisting with the mathematical derivations. Dr. Czosnyka is on unpaid leave from Warsaw University of Technology, Warsaw, Poland. Dr. Eklund was supported by grant 621-2005-3047 from Swedish Research Council.
PY - 2007/8
Y1 - 2007/8
N2 - The brain and the spinal cord are contained in a cavity and are surrounded by cerebrospinal fluid (CSF), which provides physical support for the brain and a cushion against external pressure. Hydrocephalus is a disease, associated with disturbances in the CSF dynamics, which can be surgically treated by inserting a shunt or third ventriculostomy. This review describes the physiological background, modeling and mathematics, and the investigational methods for determining the CSF dynamic properties, with specific focus on the CSF outflow resistance, Rout. A model of the cerebrospinal fluid dynamic system, with a pressure-independent Rout, a pressure-dependent compliance and a constant formation rate of CSF is widely accepted. Using mathematical expressions calculated from the model, along with active infusion of artificial CSF and observation of corresponding change in ICP allows measurements of CSF dynamics. Distinction between normal pressure hydrocephalus and differential diagnoses, prediction of clinical response to shunting and the possibility of assessment of shunt function in vivo are the three most important applications of infusion studies in clinical practice.
AB - The brain and the spinal cord are contained in a cavity and are surrounded by cerebrospinal fluid (CSF), which provides physical support for the brain and a cushion against external pressure. Hydrocephalus is a disease, associated with disturbances in the CSF dynamics, which can be surgically treated by inserting a shunt or third ventriculostomy. This review describes the physiological background, modeling and mathematics, and the investigational methods for determining the CSF dynamic properties, with specific focus on the CSF outflow resistance, Rout. A model of the cerebrospinal fluid dynamic system, with a pressure-independent Rout, a pressure-dependent compliance and a constant formation rate of CSF is widely accepted. Using mathematical expressions calculated from the model, along with active infusion of artificial CSF and observation of corresponding change in ICP allows measurements of CSF dynamics. Distinction between normal pressure hydrocephalus and differential diagnoses, prediction of clinical response to shunting and the possibility of assessment of shunt function in vivo are the three most important applications of infusion studies in clinical practice.
UR - http://www.scopus.com/inward/record.url?scp=34547644271&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34547644271&partnerID=8YFLogxK
U2 - 10.1007/s11517-007-0199-5
DO - 10.1007/s11517-007-0199-5
M3 - Review article
C2 - 17634761
AN - SCOPUS:34547644271
VL - 45
SP - 719
EP - 735
JO - Medical and Biological Engineering and Computing
JF - Medical and Biological Engineering and Computing
SN - 0140-0118
IS - 8
ER -