Abstract
<p class="lead">The aim of this comprehensive study is to quantify the velocity variation of cerebrospinal fluid (CSF) for narrowest point in aqueduct of Sylvia (AqSylv) of normal patients and normal pressure hydrocephalus (NPH) patient by corresponds to its concave shapes of anteriorly and inferiorly. T1-weighted 3-T magnetic resonance images (MRI) of the head in DICOM (Digital Imaging and Communications in Medicine) format were taken from three controlled patients whose were admitted to Thammasat Hospital, Thailand. Patients were 29 to 52 y of age with two normal patients and one (NPH) patient. DICOM files were three-dimensionally reconstructed by using 3D slicer software, and geometric information of an aqueduct for all three cases was noted. Solid models of the aqueduct for both normal patient and NPH condition were developed based on the geometric information. Computational fluid dynamics (CFD) were analyzed to quantify the CSF velocity variation throughout the narrowest point of the aqueduct for both cases, i.e. normal and NPH condition. Retrospective results of “mathematical model for dynamics of CSF through the aqueduct of Sylvia based on an analogy of arterial dilation and contraction” were used as initial data for ANSYS CFX analysis. The results showed the CSF flow through the aqueduct in a pulsatile pattern in both cases. At the narrowest point of the aqueduct, amplitude of peak CSF velocity for NPH patients was significantly higher than that of normal patient. CSF velocity variation throughout the aqueduct co-relates with the pressure gradient inside the aqueduct and increased in the third ventricle direction.<strong></strong></p>
Highlights
The aqueduct of Sylvia (AqSylv) is a tube which connects the third and fourth ventricles
Measured mean morphologic of the ventricular system was, width of lateral ventricles 30 mm; length of aqueduct 14.1 mm; diameter of the narrowest point of the aqueduct for a normal patient 0.9 mm; inclination of aqueduct relates to the third and fourth ventricles is 26 °and 18 ° respectively [10], diameter of the narrowest point of the aqueduct for hydrocephalus patient were reported as 0.5 mm and we assumed it as 0.6 mm for normal pressure hydrocephalus (NPH) patient
Velocity variation of cerebrospinal fluid (CSF) through the narrowest point of the aqueduct for one R-R cycle was plotted which was based on the same input conditions on Computational fluid dynamics (CFD) analysis
Summary
The aqueduct of Sylvia (AqSylv) is a tube which connects the third and fourth ventricles. Dominant percentage of CSF manufacturers in lateral, third ventricles and moves as a bulk flow through the AqSylv to the fourth ventricle [4]. Malfunctioning in any CSF motion would increase the volume of the ventricles by resulting in the higher built-in pressure inside the ventricle system and enlarging towards the skull [7]. The lateral ventricles and medial parts of the temporal lobes expand owing to accumulated CSF inside and compress the aqueduct as a consequence of volume compensation in the skull. The pressure inside the fourth ventricle declined and caused the aqueduct to close more tightly. These phenomena were illustrated as aqueductal stenosis, a root cause of hydrocephalus [8]
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