title: Computational Modeling of Venous Sinus Stenosis in Idiopathic Intracranial Hypertension.
abstract: OBJECTIVE
  Idiopathic intracranial hypertension has been associated with dural venous sinus stenosis in some patients, but the hemodynamic environment of the dural venous sinuses has not been quantitatively described. Here, we present the first such computational fluid dynamics model by using patient-specific blood pressure measurements.
  
  
  METHODS
  Six patients with idiopathic intracranial hypertension and at least 1 stenosis or atresia at the transverse/sigmoid sinus junction underwent MR venography followed by cerebral venography and manometry throughout the dural venous sinuses. Patient-specific computational fluid dynamics models were created by using MR venography anatomy, with venous pressure measurements as boundary conditions. Blood flow and wall shear stress were calculated for each patient.
  
  
  RESULTS
  Computational models of the dural venous sinuses were successfully reconstructed in all 6 patients with patient-specific boundary conditions. Three patients demonstrated a pathologic pressure gradient (≥8 mm Hg) across 4 dural venous sinus stenoses. Small sample size precludes statistical comparisons, but average overall flow throughout the dural venous sinuses of patients with pathologic pressure gradients was higher than in those without them (1041.00 ± 506.52 mL/min versus 358.00 ± 190.95 mL/min). Wall shear stress was also higher across stenoses in patients with pathologic pressure gradients (37.66 ± 48.39 Pa versus 7.02 ± 13.60 Pa).
  
  
  CONCLUSIONS
  The hemodynamic environment of the dural venous sinuses can be computationally modeled by using patient-specific anatomy and physiologic measurements in patients with idiopathic intracranial hypertension. There was substantially higher blood flow and wall shear stress in patients with pathologic pressure gradients.
authors.affiliation: From the Departments of Neurological Surgery (M.R.L., L.J.K.) mlevitt@uw.edu jahirsch@mgh.harvard.edu.|Radiology (M.R.L., L.J.K.).|Mechanical Engineering (M.R.L., P.M.M., A.A.), University of Washington, Seattle, Washington.
authors.forename: M R
authors.identifier: http://orcid.org/0000-0003-3612-3347
authors.initials: MR
authors.lastname: Levitt
authors.affiliation: Mechanical Engineering (M.R.L., P.M.M., A.A.), University of Washington, Seattle, Washington.
authors.forename: P M
authors.identifier: http://orcid.org/0000-0002-3602-988X
authors.initials: PM
authors.lastname: McGah
authors.affiliation: Department of Neurosurgery (K.M., F.C.A., C.G.M., M.Y.S.K.), Barrow Neurological Institute, Phoenix, Arizona.
authors.forename: K
authors.identifier: http://orcid.org/0000-0002-7984-5801
authors.initials: K
authors.lastname: Moon
authors.affiliation: Department of Neurosurgery (K.M., F.C.A., C.G.M., M.Y.S.K.), Barrow Neurological Institute, Phoenix, Arizona.
authors.forename: F C
authors.identifier: http://orcid.org/0000-0003-2655-3810
authors.initials: FC
authors.lastname: Albuquerque
authors.affiliation: Department of Neurosurgery (K.M., F.C.A., C.G.M., M.Y.S.K.), Barrow Neurological Institute, Phoenix, Arizona.
authors.forename: C G
authors.identifier: http://orcid.org/0000-0001-7372-7049
authors.initials: CG
authors.lastname: McDougall
authors.affiliation: Department of Neurosurgery (K.M., F.C.A., C.G.M., M.Y.S.K.), Barrow Neurological Institute, Phoenix, Arizona.
authors.forename: M Y S
authors.identifier: http://orcid.org/0000-0002-5923-1255
authors.initials: MYS
authors.lastname: Kalani
authors.affiliation: From the Departments of Neurological Surgery (M.R.L., L.J.K.).|Radiology (M.R.L., L.J.K.).
authors.forename: L J
authors.identifier: http://orcid.org/0000-0002-2544-5140
authors.initials: LJ
authors.lastname: Kim
authors.affiliation: Mechanical Engineering (M.R.L., P.M.M., A.A.), University of Washington, Seattle, Washington.
authors.forename: A
authors.identifier: http://orcid.org/0000-0002-5832-2999
authors.initials: A
authors.lastname: Aliseda