Effect of endoscopic third ventriculostomy on cerebrospinal fluid pressure in the cerebral ventricles

Azadeh Farnoush; Kristy Tan; Lauriane Juge; Lynne E Bilston; Shaokoon Cheng

doi:10.1016/j.jocn.2015.04.025

Effect of endoscopic third ventriculostomy on cerebrospinal fluid pressure in the cerebral ventricles

J Clin Neurosci. 2016 Jan:23:63-67. doi: 10.1016/j.jocn.2015.04.025. Epub 2015 Aug 12.

Authors

Azadeh Farnoush¹, Kristy Tan², Lauriane Juge³, Lynne E Bilston⁴, Shaokoon Cheng⁵

Affiliations

¹ Faculty of Science and Engineering, Macquarie University, NSW, Australia.
² Neuroscience Research Australia, Randwick, NSW, Australia; Graduate School of Biomedical Engineering, University of New South Wales, NSW, Australia.
³ Neuroscience Research Australia, Randwick, NSW, Australia; School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.
⁴ Neuroscience Research Australia, Randwick, NSW, Australia; Prince of Wales Clinical School, University of New South Wales, NSW, Australia.
⁵ Faculty of Science and Engineering, Macquarie University, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia. Electronic address: shaokoon.cheng@mq.edu.au.

PMID: 26277641
DOI: 10.1016/j.jocn.2015.04.025

Abstract

We aimed to show how endoscopic third ventriculostomy (ETV) treatment may affect cerebrospinal fluid (CSF) flow dynamics in hydrocephalus, with and without aqueductal stenosis. Hydrocephalus is a neurological disorder which is characterized by enlarged brain ventricles. The periodic motion of CSF flow as a function of the cardiac cycle was prescribed as the inlet boundary condition at the foramen of Monro, and ETV was modeled as a 5mm diameter hole in the anterior wall of the third ventricle. The results show that ETV reduces the pressure in the ventricles by nine-fold in the model with aqueductal stenosis, and three-fold in the model without aqueductal stenosis. More importantly, ETV changes the temporal characteristics of the CSF pressure waveform in the model without aqueductal stenosis, such that there is higher pressure in the ventricle during diastole. This study suggests that changes in the temporal characteristics of the CSF pressure waveform in the ventricles may be the reason why ETV treatment is not effective for hydrocephalus without aqueductal stenosis.

Keywords: Cerebral ventricles; Cerebrospinal fluid; Computational fluid dynamics; Endoscopic third ventriculostomy; Hydrocephalus.

MeSH terms

Brain / surgery
Cerebral Aqueduct / abnormalities
Cerebral Aqueduct / surgery
Cerebrospinal Fluid Pressure / physiology*
Genetic Diseases, X-Linked / cerebrospinal fluid
Genetic Diseases, X-Linked / surgery
Humans
Hydrocephalus / cerebrospinal fluid*
Hydrocephalus / surgery*
Neuroendoscopy
Third Ventricle / surgery*
Ventriculostomy / methods*

Supplementary concepts

Hydrocephalus, X-linked