gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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CSF flow imaging in the acute phase of meningeal haemorrhage

Meeting Abstract

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  • corresponding author G. Paradot - Service de Neurochirurgie, CHU Nord d'Amiens
  • O. Balédent - Service de Biophysique et de Traitement de l'Image, CHU Nord d'Amiens
  • C. Gondry-Jouet - Service de Neuroradiologie, CHU Nord d'Amiens
  • Gars D. Le - Service de Neurochirurgie, CHU Nord d'Amiens

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP008

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0276.shtml

Published: May 4, 2005

© 2005 Paradot et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

The study of cerebrospinal fluid (CSF) flow dynamics by cine phase-contrast MR imaging shows that CSF oscillations are synchronized with cerebral blood flow and are also involved in the control of variations of intracranial pressure during the cardiac cycle. The aim of this study was to investigate the possible alterations of CSF flow dynamics during the acute phase of meningeal haemorrhage (MH).

Methods

Eleven patients with MH confirmed by CT scan were examined by MR imaging during the first 24 hours after rupture of the aneurysm. MR imaging comprised morphological sequences and flow dynamic sequences for quantification of CSF oscillations and cerebral blood flow rates. CSF oscillations were recorded at the cerebral aqueduct, cisterna pontis and C2-C3 subarachnoid space (SAS), where a vascular sequence was also performed to quantify internal carotid artery and vertebral artery blood flow. The oscillations measured in this population were compared to oscillations of a population of 44 control subjects and a difference of at least two standard deviation was used to define a hyperdynamic or hypodynamic appearance of CSF flow. Dilatation of the ventricular system was determined on radiographs by two neuroradiologists and a neurosurgeon.

Results

No significant modification of cerebral blood flow was demonstrated in the patients of our population. Only 5 patients presented normal ventricular CSF flow, 1 patient presented hypodynamic flow and 5 patients presented hyperdynamic flow. Five patients had normal cervical CSF flow and 5 patients presented hyperdynamic flow. Patients with no morphological signs of ventricular dilatation presented either hypodynamic or normal ventricular CSF flow or hyperdynamic ventricular CSF flow associated with hyperdynamic cervical CSF flow. The 2 patients with ventricular dilatation all presented hyperdynamic ventricular CSF flow associated with normal cervical CSF flow.

Conclusions

Abnormal CSF flow dynamics were demonstrated suggesting the hypothesis that bleeding increases intracranial volume and induces a reduction of cerebral compliance and an increase of intracranial pressure. When bleeding causes increased resistance to flow in the subarachnoid spaces, there are increased oscillations in the ventricular system would therefore predispose to dilatation. This is the first study to quantify the impact of bleeding on cerebral hydrodynamics and the development of ventricular dilatation.