Biomedical subjects

D F Fletcher

Publications and source records attributed to D F Fletcher.

3 recordsLinked to original sources

PubMed2006

Focal spinal arachnoiditis increases subarachnoid space pressure: a computational study.

BACKGROUND: Enlarging fluid filled cystic cavitations form within the spinal cord in up to 28% of spinal cord injured patients. These post-traumatic syrinxes can cause neurological deterioration and current treatment results are unsatisfactory. Localized scar tissue (arachnoiditis) within the subarachnoid space at the level of injury has been suggested to be involved in the pathogenesis of syrinx formation. This study tests the hypothesis that pressure pulses in the subarachnoid space are accentuated adjacent to regions of arachnoiditis, which may drive fluid into the spinal cord and contribute to syrinx formation. METHODS: An axisymmetric, cylindrical computational fluid dynamics model was developed to represent the subarachnoid space under normal physiological conditions and in the presence of arachnoiditis. Cerebrospinal fluid flow into the model was estimated from magnetic resonance imaging flow studies. Arachnoiditis was modelled as a porous obstruction in the subarachnoid space. FINDINGS: Peak fluid pressures were higher above the obstruction than in the absence of obstruction. The peak pressures were strongly dependent on the permeability of the obstruction. INTERPRETATION: Elevations in subarachnoid space pressures due to arachnoiditis may facilitate fluid flow into the spinal cord, enhancing syrinx formation. This suggests that it may be worthwhile to investigate strategies that inhibit arachnoiditis or minimize systolic pressure peaks for treating or preventing syringomyelia.

Arachnoiditis↗

PubMed1999

Computer modelling of the cerebrospinal fluid flow dynamics of aqueduct stenosis.

As the craniospinal space is a pressure loaded system it is difficult to conceptualize and understand the flow dynamics through the ventricular system. Aqueduct stenosis compromises flow, increasing the pressure required to move cerebrospinal fluid (CSF) through the ventricles. Under normal circumstances, less than one pascal (1 Pa) of pressure is required to move a physiological flow of CSF through the aqueduct. This is too small to measure using clinical pressure transducers. A computational fluid dynamics (CFD) program, CFX, has been used to model two forms of aqueduct stenosis: simple narrowing and forking of the aqueduct. This study shows that with mild stenoses, the increase in pressure required to drive flow becomes significant (86-125 Pa), which may result in an increased transmantle pressure difference but not necessarily an increased intraventricular pressure. Severe stenoses will result in both. Wall shear stresses increase concomitantly and may contribute to local damage of the aqueduct wall and further gliosis with narrowing.

Cerebrospinal Fluid↗

PubMed1996

Fluid dynamics of the cerebral aqueduct.

Despite a multitude of theories describing the mechanics of the intracranial spaces in diseases such as hydrocephalus, little is known about the mechanics of normal CSF flow. A pressure difference is required to drive CSF flow. Knowing that the pressure difference driving fluid through the aqueduct is beyond the resolution of clinically used pressure transducers, a computational fluid dynamics program was used to analyze flow through an aqueduct shape. Flow through this duct was compared with that through a cylinder and through a double hourglass. Both steady and oscillating flows were tested, revealing that only 1.1 Pa of pressure is required to move CSF through the aqueduct. This suggests that normally less than 5% of the total resistance to CSF flow within the CSF pathways occurs in the aqueduct.

Cerebral Aqueduct↗