Effect of endoscopic third ventriculostomy on cerebrospinal fluid pressure in the cerebral ventricles.
We aimed to show how endoscopic third ventriculostomy (ETV) treatment may affect cerebrospinal fluid (CSF) flow dynamics in hydrocephalus, with and without aqueductal stenosis. Hydrocephalus is a neurological disorder which is characterized by enlarged brain ventricles. The periodic motion of CSF flow as a function of the cardiac cycle was prescribed as the inlet boundary condition at the foramen of Monro, and ETV was modeled as a 5mm diameter hole in the anterior wall of the third ventricle. The results show that ETV reduces the pressure in the ventricles by nine-fold in the model with aqueductal stenosis, and three-fold in the model without aqueductal stenosis. More importantly, ETV changes the temporal characteristics of the CSF pressure waveform in the model without aqueductal stenosis, such that there is higher pressure in the ventricle during diastole. This study suggests that changes in the temporal characteristics of the CSF pressure waveform in the ventricles may be the reason why ETV treatment is not effective for hydrocephalus without aqueductal stenosis.
Faculty of Science and Engineering, Macquarie University, NSW, Australia.
Azadeh
A
Farnoush
Neuroscience Research Australia, Randwick, NSW, Australia; Graduate School of Biomedical Engineering, University of New South Wales, NSW, Australia.
Kristy
K
Tan
Neuroscience Research Australia, Randwick, NSW, Australia; School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.
Lauriane
L
Juge
Neuroscience Research Australia, Randwick, NSW, Australia; Prince of Wales Clinical School, University of New South Wales, NSW, Australia.
Lynne E
LE
Bilston
Faculty of Science and Engineering, Macquarie University, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia. Electronic address: shaokoon.cheng@mq.edu.au.
Shaokoon
S
Cheng
D001921:Brain / Q000601:surgery; D002535:Cerebral Aqueduct / Q000002:abnormalities / Q000601:surgery; D015170:Cerebrospinal Fluid Pressure / Q000502:physiology*; D040181:Genetic Diseases, X-Linked / Q000134:cerebrospinal fluid / Q000601:surgery; D006801:Humans; D006849:Hydrocephalus / Q000134:cerebrospinal fluid* / Q000601:surgery*; D044583:Neuroendoscopy; D020542:Third Ventricle / Q000601:surgery*; D014696:Ventriculostomy / Q000379:methods*
Cerebral ventricles; Cerebrospinal fluid; Computational fluid dynamics; Endoscopic third ventriculostomy; Hydrocephalus