Computer Modelling Study to Investigate the Pathogenesis of Syringomyelia Related to Chiari Malformation

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Syringomyelia is a potentially disastrous progressive neurological condition characterised by the presence of fluid-filled cysts (syrinxes) in the spinal cord. The lack of understanding of the physical mechanisms that contribute to the formation and growth of cysts is one of the main factors that limit the success of currently available surgical treatments. Generally, it is believed that the condition originates from impediments to the normal movement of cerebrospinal fluid (a clear liquid that bathes the brain and the spinal cord) in the spinal cavity. Theories that attribute formation and growth of cysts to abnormal patterns of the cerebrospinal fluid circulation are known as hydrodynamic hypotheses on the origins of syringomyelia and they have traditionally been based on clinical observation and simple physical rationale. More recently, computer modelling of the cerebrospinal fluid motion within the spinal cavity has emerged as an alternative approach for gaining insights into the pathogenesis of the condition. This approach is adopted for this study. Various modelling strategies have been used in the existing studies; for this project it is proposed that modelling be conducted simultaneously on two different levels of physiological approximation, resulting in two models, each of which is intended to examine a specific aspect of the problem in question. For both of the models developed, new elements will be added to address the limitations of the current theories. In the final stage of the project, simulations involving one-way coupling of the models will be conducted. The goal is to generate new ideas on the pathogenesis of syringomyelia and the ways in which it can be managed. However, the modelling will also be relevant to other problems related to the dynamics of the cerebrospinal fluid.