PDF(Pubmed)
Abstract：
Chiari type 1 malformation is a neurological disorder characterized by an obstruction of the cerebrospinal fluid (CSF) circulation between the brain (intracranial) and spinal cord (spinal) compartments. Actions such as coughing might evoke spinal cord complications in patients with Chiari type 1 malformation, but the underlying mechanisms are not well understood. More insight into the impact of the obstruction on local and overall CSF dynamics can help reveal these mechanisms. Therefore, our previously developed computational fluid dynamics framework was used to establish a subject-specific model of the intracranial and upper spinal CSF space of a healthy control. In this model, we emulated a single cough and introduced porous zones to model a posterior (OBS-1), mild (OBS-2), and severe posterior-anterior (OBS-3) obstruction. OBS-1 and OBS-2 induced minor changes to the overall CSF pressures, while OBS-3 caused significantly larger changes with a decoupling between the intracranial and spinal compartment. Coughing led to a peak in overall CSF pressure. During this peak, pressure differences between the lateral ventricles and the spinal compartment were locally amplified for all degrees of obstruction. These results emphasize the effects of coughing and indicate that severe levels of obstruction lead to distinct changes in intracranial pressure.
摘要：
Chiari1型畸形是一种神经系统疾病，其特征是脑（颅内）和脊髓（脊髓）隔室之间的脑脊液（CSF）循环阻塞。咳嗽等行为可能会引起Chiari1型畸形患者的脊髓并发症，但是潜在的机制还没有得到很好的理解。更深入地了解阻塞对局部和整体CSF动力学的影响可以帮助揭示这些机制。因此,我们先前开发的计算流体力学框架用于建立健康对照者颅内和脊髓上段CSF间隙的受试者特异性模型.在这个模型中,我们模拟了一次咳嗽，并引入了多孔区来模拟后咳嗽(OBS-1)，轻度（OBS-2），和严重的后前（OBS-3）梗阻。OBS-1和OBS-2引起脑脊液总体压力的微小变化，而OBS-3引起明显更大的变化，颅内和脊髓室之间脱钩。咳嗽导致总体CSF压力达到峰值。在这个高峰期间,对于所有程度的梗阻,侧脑室和脊髓室之间的压差均局部放大.这些结果强调了咳嗽的影响，并表明严重程度的阻塞会导致颅内压的明显变化。
