title: Direct numerical simulation of transitional hydrodynamics of the cerebrospinal fluid in Chiari I malformation: The role of cranio-vertebral junction.
abstract: Obstruction to the cerebrospinal fluid (CSF) outflow caused by the herniation of cerebellar tonsils as a result of Chiari malformation type I leads to altered CSF hydrodynamics. This contribution explores the minutest characteristics of the CSF hydrodynamics in cervical subarachnoid space (SAS) of a healthy subject and 2 Chiari patients by performing highly resolved direct numerical simulation. The lattice Boltzmann method is used for the simulations because of its scalability on modern supercomputers that allow us to simulate up to approximately 109cells while resolving the Kolmogorov microscales. The results depict that whereas the complex CSF flow remains largely laminar in the SAS of a healthy subject, constriction of the cranio-vertebral junction in Chiari I patients causes manifold fluctuations in the hydrodynamics of the CSF. These fluctuations resemble a flow that is in a transitional regime rather than laminar or fully developed turbulence. The fluctuations confine near the cranio-vertebral junction and are triggered due to the tonsillar herniation, which perturbs the flow as a result of altered anatomy of the SAS.
authors.affiliation: Simulation Techniques and Scientific Computing, University of Siegen, Hölderlinstr. 3, 57076, Siegen, Germany.|Center for Biomedical Computing, Simula Research Laboratory, Lysaker, N-1325, Norway.
authors.forename: Kartik
authors.identifier: 0000-0002-6540-9304
authors.initials: K
authors.lastname: Jain
authors.affiliation: Department of Radiology and Nuclear Medicine, Oslo University Hospital, Nydalen, Oslo, N-0424, Norway.
authors.forename: Geir
authors.initials: G
authors.lastname: Ringstad
authors.affiliation: Department of Neurosurgery, Oslo University Hospital, Nydalen, Oslo, N-0424, Norway.|Faculty of Medicine, University of Oslo, Oslo, 0316, Norway.
authors.forename: Per-Kristian
authors.initials: PK
authors.lastname: Eide
authors.affiliation: Department of Mathematics, University of Oslo, Oslo, 0316, Norway.|Center for Biomedical Computing, Simula Research Laboratory, Lysaker, N-1325, Norway.
authors.forename: Kent-André
authors.initials: KA
authors.lastname: Mardal
mesh_terms: D000328:Adult; D001139:Arnold-Chiari Malformation / Q000134:cerebrospinal fluid* / Q000473:pathology* / Q000503:physiopathology; D016022:Case-Control Studies; D002555:Cerebrospinal Fluid; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D057446:Hydrodynamics; D008279:Magnetic Resonance Imaging; D008875:Middle Aged
keywords: Chiari malformation; Kolmogorov scales; cerebrospinal fluid; subarachnoid space; transitional flow