Finite element analysis of periventricular lucency in hydrocephalus: extravasation or transependymal CSF absorption?

Hakseung Kim, Eun Jin Jeong, Dae Hyeon Park, Zofia Czosnyka, Byung C. Yoon, Keewon Kim, Marek Czosnyka, Dong Ju Kim

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

OBJECTIVE: Periventricular lucency (PVL) is often observed in the hydrocephalic brain on CT or MRI. Earlier studies have proposed the extravasation of ventricular CSF into the periventricular white matter or transependymal CSF absorption as possible causes of PVL in hydrocephalus. However, there is insufficient evidence for either theory to be conclusive.

METHODS: A finite element (FE) model of the hydrocephalic brain with detailed anatomical geometry was constructed to investigate the possible mechanism of PVL in hydrocephalus. The initiation of hydrocephalus was modeled by applying a transmantle pressure gradient (TPG). The model was exposed to varying TPGs to investigate the effects of different geometrical characteristics on the distribution of PVL. The edema map was derived based on the interstitial pore pressure.

RESULTS: The model simulated the main radiological features of hydrocephalus, i.e., ventriculomegaly and PVL. The degree of PVL, assessed by the pore pressure, was prominent in mild to moderate ventriculomegaly. As the degree of ventriculomegaly exceeded certain values, the pore pressure across the cerebrum became positive, thus inducing the disappearance of PVL.

CONCLUSIONS: The results are in accordance with common clinical findings of PVL. The degree of ventriculomegaly significantly influences the development of PVL, but two factors were not linearly correlated. The results are indicative of the transependymal CSF absorption as a possible cause of PVL, but the extravasation theory cannot be formally rejected.

Original languageEnglish
Pages (from-to)334-341
Number of pages8
JournalJournal of Neurosurgery
Volume124
Issue number2
DOIs
Publication statusPublished - 2016 Feb 1

Fingerprint

Finite Element Analysis
Hydrocephalus
Pressure
Brain
Cerebrum
Edema

Keywords

  • biomechanics
  • FE = finite element
  • finite element model
  • hydrocephalus
  • ICP = intracranial pressure
  • intracranial pressure
  • ISF = interstitial fluid
  • periventricular lucency
  • PVL = periventricular lucency
  • TPG = transmantle pressure gradient
  • transmantle pressure gradient

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Finite element analysis of periventricular lucency in hydrocephalus : extravasation or transependymal CSF absorption? / Kim, Hakseung; Jeong, Eun Jin; Park, Dae Hyeon; Czosnyka, Zofia; Yoon, Byung C.; Kim, Keewon; Czosnyka, Marek; Kim, Dong Ju.

In: Journal of Neurosurgery, Vol. 124, No. 2, 01.02.2016, p. 334-341.

Research output: Contribution to journalArticle

Kim, Hakseung ; Jeong, Eun Jin ; Park, Dae Hyeon ; Czosnyka, Zofia ; Yoon, Byung C. ; Kim, Keewon ; Czosnyka, Marek ; Kim, Dong Ju. / Finite element analysis of periventricular lucency in hydrocephalus : extravasation or transependymal CSF absorption?. In: Journal of Neurosurgery. 2016 ; Vol. 124, No. 2. pp. 334-341.
@article{cfec955155b14a82a935c7735b98507b,
title = "Finite element analysis of periventricular lucency in hydrocephalus: extravasation or transependymal CSF absorption?",
abstract = "OBJECTIVE: Periventricular lucency (PVL) is often observed in the hydrocephalic brain on CT or MRI. Earlier studies have proposed the extravasation of ventricular CSF into the periventricular white matter or transependymal CSF absorption as possible causes of PVL in hydrocephalus. However, there is insufficient evidence for either theory to be conclusive.METHODS: A finite element (FE) model of the hydrocephalic brain with detailed anatomical geometry was constructed to investigate the possible mechanism of PVL in hydrocephalus. The initiation of hydrocephalus was modeled by applying a transmantle pressure gradient (TPG). The model was exposed to varying TPGs to investigate the effects of different geometrical characteristics on the distribution of PVL. The edema map was derived based on the interstitial pore pressure.RESULTS: The model simulated the main radiological features of hydrocephalus, i.e., ventriculomegaly and PVL. The degree of PVL, assessed by the pore pressure, was prominent in mild to moderate ventriculomegaly. As the degree of ventriculomegaly exceeded certain values, the pore pressure across the cerebrum became positive, thus inducing the disappearance of PVL.CONCLUSIONS: The results are in accordance with common clinical findings of PVL. The degree of ventriculomegaly significantly influences the development of PVL, but two factors were not linearly correlated. The results are indicative of the transependymal CSF absorption as a possible cause of PVL, but the extravasation theory cannot be formally rejected.",
keywords = "biomechanics, FE = finite element, finite element model, hydrocephalus, ICP = intracranial pressure, intracranial pressure, ISF = interstitial fluid, periventricular lucency, PVL = periventricular lucency, TPG = transmantle pressure gradient, transmantle pressure gradient",
author = "Hakseung Kim and Jeong, {Eun Jin} and Park, {Dae Hyeon} and Zofia Czosnyka and Yoon, {Byung C.} and Keewon Kim and Marek Czosnyka and Kim, {Dong Ju}",
year = "2016",
month = "2",
day = "1",
doi = "10.3171/2014.11.JNS141382",
language = "English",
volume = "124",
pages = "334--341",
journal = "Journal of Neurosurgery",
issn = "0022-3085",
publisher = "American Association of Neurological Surgeons",
number = "2",

}

TY - JOUR

T1 - Finite element analysis of periventricular lucency in hydrocephalus

T2 - extravasation or transependymal CSF absorption?

AU - Kim, Hakseung

AU - Jeong, Eun Jin

AU - Park, Dae Hyeon

AU - Czosnyka, Zofia

AU - Yoon, Byung C.

AU - Kim, Keewon

AU - Czosnyka, Marek

AU - Kim, Dong Ju

PY - 2016/2/1

Y1 - 2016/2/1

N2 - OBJECTIVE: Periventricular lucency (PVL) is often observed in the hydrocephalic brain on CT or MRI. Earlier studies have proposed the extravasation of ventricular CSF into the periventricular white matter or transependymal CSF absorption as possible causes of PVL in hydrocephalus. However, there is insufficient evidence for either theory to be conclusive.METHODS: A finite element (FE) model of the hydrocephalic brain with detailed anatomical geometry was constructed to investigate the possible mechanism of PVL in hydrocephalus. The initiation of hydrocephalus was modeled by applying a transmantle pressure gradient (TPG). The model was exposed to varying TPGs to investigate the effects of different geometrical characteristics on the distribution of PVL. The edema map was derived based on the interstitial pore pressure.RESULTS: The model simulated the main radiological features of hydrocephalus, i.e., ventriculomegaly and PVL. The degree of PVL, assessed by the pore pressure, was prominent in mild to moderate ventriculomegaly. As the degree of ventriculomegaly exceeded certain values, the pore pressure across the cerebrum became positive, thus inducing the disappearance of PVL.CONCLUSIONS: The results are in accordance with common clinical findings of PVL. The degree of ventriculomegaly significantly influences the development of PVL, but two factors were not linearly correlated. The results are indicative of the transependymal CSF absorption as a possible cause of PVL, but the extravasation theory cannot be formally rejected.

AB - OBJECTIVE: Periventricular lucency (PVL) is often observed in the hydrocephalic brain on CT or MRI. Earlier studies have proposed the extravasation of ventricular CSF into the periventricular white matter or transependymal CSF absorption as possible causes of PVL in hydrocephalus. However, there is insufficient evidence for either theory to be conclusive.METHODS: A finite element (FE) model of the hydrocephalic brain with detailed anatomical geometry was constructed to investigate the possible mechanism of PVL in hydrocephalus. The initiation of hydrocephalus was modeled by applying a transmantle pressure gradient (TPG). The model was exposed to varying TPGs to investigate the effects of different geometrical characteristics on the distribution of PVL. The edema map was derived based on the interstitial pore pressure.RESULTS: The model simulated the main radiological features of hydrocephalus, i.e., ventriculomegaly and PVL. The degree of PVL, assessed by the pore pressure, was prominent in mild to moderate ventriculomegaly. As the degree of ventriculomegaly exceeded certain values, the pore pressure across the cerebrum became positive, thus inducing the disappearance of PVL.CONCLUSIONS: The results are in accordance with common clinical findings of PVL. The degree of ventriculomegaly significantly influences the development of PVL, but two factors were not linearly correlated. The results are indicative of the transependymal CSF absorption as a possible cause of PVL, but the extravasation theory cannot be formally rejected.

KW - biomechanics

KW - FE = finite element

KW - finite element model

KW - hydrocephalus

KW - ICP = intracranial pressure

KW - intracranial pressure

KW - ISF = interstitial fluid

KW - periventricular lucency

KW - PVL = periventricular lucency

KW - TPG = transmantle pressure gradient

KW - transmantle pressure gradient

UR - http://www.scopus.com/inward/record.url?scp=84976527454&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84976527454&partnerID=8YFLogxK

U2 - 10.3171/2014.11.JNS141382

DO - 10.3171/2014.11.JNS141382

M3 - Article

C2 - 26274984

AN - SCOPUS:84976527454

VL - 124

SP - 334

EP - 341

JO - Journal of Neurosurgery

JF - Journal of Neurosurgery

SN - 0022-3085

IS - 2

ER -