PMID- 30443816
OWN - NLM
STAT- MEDLINE
DCOM- 20200123
LR  - 20200123
IS  - 0942-0940 (Electronic)
IS  - 0001-6268 (Linking)
VI  - 161
IP  - 2
DP  - 2019 Feb
TI  - Magnitude and direction of aqueductal cerebrospinal fluid flow: large variations 
      in patients with intracranial aneurysms with or without a previous subarachnoid 
      hemorrhage.
PG  - 247-256
LID - 10.1007/s00701-018-3730-6 [doi]
AB  - BACKGROUND: Net cerebrospinal fluid (CSF) flow within the cerebral aqueduct is 
      usually considered to be antegrade, i.e., from the third to the fourth ventricle 
      with volumes ranging between 500 and 600 ml over 24 h. Knowledge of individual 
      CSF flow dynamics, however, is hitherto scarcely investigated. In order to 
      explore individual CSF flow rate and direction, we assessed net aqueductal CSF 
      flow in individuals with intracranial aneurysms with or without a previous 
      subarachnoid hemorrhage (SAH). METHODS: A prospective observational study was 
      performed utilizing phase-contrast magnetic resonance imaging (PC-MRI) to 
      determine the magnitude and direction of aqueductal CSF flow with an in-depth, 
      pixel-by-pixel approach. Estimation of net flow was used to calculate CSF flow 
      volumes over 24 h. PC-MRI provides positive values when flow is retrograde. 
      RESULTS: The study included eight patients with intracranial aneurysms. Four were 
      examined within days after their SAH; three were studied in the chronic stage 
      after SAH while one patient had an unruptured intracranial aneurysm. There was a 
      vast variation in magnitude and direction of aqueductal CSF flow between 
      individuals. Net aqueductal CSF flow was retrograde, i.e., directed towards the 
      third ventricle in 5/8 individuals. For the entire patient cohort, the estimated 
      net aqueductal CSF volumetric flow rate (independent of direction) was median 
      898 ml/24 h (ranges 69 ml/24 h to 12.9 l/24 h). One of the two individuals who 
      had a very high estimated net aqueductal CSF volumetric flow rate, 8.7 l/24 h 
      retrograde, later needed a permanent CSF shunt. CONCLUSIONS: The magnitude and 
      direction of net aqueductal CSF flow vary extensively in patients with 
      intracranial aneurysms. Following SAH, PC-MRI may offer the possibility to 
      perform individualized assessments of the CSF circulation.
FAU - Lindstrom, Erika Kristina
AU  - Lindstrom EK
AD  - Department of Mathematics, Faculty of Mathematics and Natural Sciences, 
      University of Oslo, Oslo, Norway.
FAU - Ringstad, Geir
AU  - Ringstad G
AD  - Department of Radiology and Nuclear Medicine, Oslo University Hospital, 
      Rikshospitalet, Oslo, Norway.
AD  - Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, 
      Norway.
FAU - Sorteberg, Angelika
AU  - Sorteberg A
AD  - Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, 
      Norway.
AD  - Department of Neurosurgery, Oslo University Hospital, Rikshospitalet, Pb 4950 
      Nydalen, N-0424, Oslo, Norway.
FAU - Sorteberg, Wilhelm
AU  - Sorteberg W
AD  - Department of Neurosurgery, Oslo University Hospital, Rikshospitalet, Pb 4950 
      Nydalen, N-0424, Oslo, Norway.
FAU - Mardal, Kent-Andre
AU  - Mardal KA
AD  - Department of Mathematics, Faculty of Mathematics and Natural Sciences, 
      University of Oslo, Oslo, Norway.
AD  - Department of Numerical Analysis and Scientific Computing, Simula Research 
      Laboratory, Fornebu, Norway.
FAU - Eide, Per Kristian
AU  - Eide PK
AUID- ORCID: 0000-0001-6881-9280
AD  - Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, 
      Norway. peide@ous-hf.no.
AD  - Department of Neurosurgery, Oslo University Hospital, Rikshospitalet, Pb 4950 
      Nydalen, N-0424, Oslo, Norway. peide@ous-hf.no.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20181115
PL  - Austria
TA  - Acta Neurochir (Wien)
JT  - Acta neurochirurgica
JID - 0151000
SB  - IM
CIN - Acta Neurochir (Wien). 2019 Feb;161(2):257-258. PMID: 30421028
CIN - Acta Neurochir (Wien). 2019 Feb;161(2):259-261. PMID: 30560378
MH  - Adult
MH  - Cerebral Aqueduct/*diagnostic imaging
MH  - Cerebrospinal Fluid/*physiology
MH  - Female
MH  - Humans
MH  - Intracranial Aneurysm/complications/*diagnostic imaging
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Subarachnoid Hemorrhage/complications/*diagnostic imaging
OTO - NOTNLM
OT  - Cerebral aqueduct
OT  - Cerebrospinal fluid flow
OT  - Phase-contrast magnetic resonance imaging
OT  - Subarachnoid hemorrhage
EDAT- 2018/11/18 06:00
MHDA- 2020/01/24 06:00
CRDT- 2018/11/17 06:00
PHST- 2018/06/20 00:00 [received]
PHST- 2018/11/06 00:00 [accepted]
PHST- 2018/11/18 06:00 [pubmed]
PHST- 2020/01/24 06:00 [medline]
PHST- 2018/11/17 06:00 [entrez]
AID - 10.1007/s00701-018-3730-6 [pii]
AID - 10.1007/s00701-018-3730-6 [doi]
PST - ppublish
SO  - Acta Neurochir (Wien). 2019 Feb;161(2):247-256. doi: 10.1007/s00701-018-3730-6. 
      Epub 2018 Nov 15.