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Craniovertebral surgical defects diminished CSF velocities, pressures
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Using computer simulations, researchers found that craniovertebral surgical defects tended to diminish cerebrospinal fluid velocities and pressures.
Computational fluid dynamics were used to calculate the effect of decompression surgery on cerebrospinal fluid (CSF) flow dynamics, with a focus on the posterior fossa and upper cervical spinal canal. The researchers simulated oscillatory flow in idealized 3-D models of the normal adult and the Chiari malformation type-I (CM-I) subarachnoid spaces, as well as in three models of CM-I following craniovertebral decompressions.
The researchers computed the velocities and pressures using the Navier-Stokes equations for multiple cycles of CSF flow oscillating at 80 cycles/minute. They compared pressure gradients and velocities for eight levels and plotted relative pressures and peak velocities by level from the posterior fossa to the C3-C4 levels.
Systolic velocities were found to be generally lower in postoperative models when compared with the preoperative CM models. Peak velocities were decreased with even the smallest surgical defect, the researchers wrote, but two larger surgical defects brought peak systolic velocities closer to normal.
Pressures differed in magnitude and pattern between the models evaluated, according to the researchers. A steeper pressure gradient was noted in the CM model compared with the normal model above C3-C4 but the same gradient below, whereas the postoperative models demonstrated lower pressure gradients than the normal model above C2-C3.
The two larger decompression defects had CFS pressure gradients below those seen in the normal model above C2-C3, with less-steep gradients above C-3 and a steeper gradient below, according to the researchers.
Disclosure: This study was supported by a Center of Excellence grant from the Norwegian Research Council to the Center for Biomedical Computing at Simula Research Laboratory.
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