Cerebrospinal fluid hydrodynamics in type I Chiari malformation
Cerebrospinal fluid hydrodynamics in type I Chiari malformation
复制标题
DOI：
10.1179/016164111x12962202723805
复制
发表时间：
2011-04-01
影响因子：
1.9
通讯作者：
Loth, Francis
中科院分区：
文献类型：
--
作者：
Shaffer, Nicholas;Martin, Bryn;Loth, Francis
目的：本研究的目的是回顾过去使用工程分析来检测正常人和I型Chiari畸形患者脑脊液流体动力学的研究。方法：通过PubMed检索与脑脊液流体动力学有关的文献，特别是那些利用计算流体力学或实验流动模型等方法的文献。讨论：从工程师的角度来看，I型Chiari畸形是一种异常的小脑几何形状，导致脑脊液在颅内和脊髓蛛网膜下腔之间流动的阻力增加。因此，了解脊髓蛛网膜下腔脑脊液的流体动力学对诊断和治疗I型Chiari畸形一直被认为是重要的。蛛网膜下腔脑脊液运动的流体动力学定量可以更好地反映疾病的病理生理学，并与目前临床使用的几何磁共振测量相结合作为预后指标。该综述讨论了试图通过计算和实验模型来量化脑脊液运动的流体动力学的研究结果，并对获得结果的方法进行了评论。结论：研究人员发现I型Chiari畸形患者的脑脊液速度和压力与健康受试者相比存在差异。然而，需要进一步的研究来确定流体动力学参数的变化之间的因果关系，如脑脊液速度、压力、流动阻力和颅脊髓顺应性与临床方面如神经症状、严重程度的放射学证据和手术成功之间的关系。
Purpose: The objective of this study was to review past studies that have used engineering analysis to examine cerebrospinal fluid hydrodynamics in cranial and spinal subarachnoid spaces in both healthy humans and those affected by type I Chiari malformation.Methods: A PubMed search of literature pertaining to cerebrospinal fluid hydrodynamics was performed with a particular focus on those that utilized methods such as computational fluid dynamics or experimental flow modeling.Discussion: From the engineer's perspective, type I Chiari malformation is an abnormal geometry of the cerebellum that causes increased resistance to cerebrospinal fluid flow between the intracranial and spinal subarachnoid space. As such, understanding the hydrodynamics of cerebrospinal fluid in the craniospinal subarachnoid space has long been thought to be important in the diagnosis and management of type I Chiari malformation. Hydrodynamic quantification of cerebrospinal fluid motion in the subarachnoid space may better reflect the pathophysiology of the disorder and serve as a prognostic indicator in conjunction with geometric magnetic resonance measurements that are currently used clinically. This review discusses the results of studies that have sought to quantify the hydrodynamics of cerebrospinal fluid motion using computational and experimental modeling and critiques the methods by which the results were obtained.Conclusion: Researchers have found differences in cerebrospinal fluid velocities and pressures in type I Chiari malformation patients compared to healthy subjects. However, further research is necessary to determine the causal relationship between changes to hydrodynamic parameters such as cerebrospinal fluid velocity, pressure, resistance to flow, and craniospinal compliance and clinical aspects such as neurological symptoms, radiological evidence of severity, and surgical success.