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Porohyperelastic anatomical models for hydrocephalus and idiopathic intracranial hypertension


Type

Article

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Authors

Kim, Hakseung 
Min, Byoung-Kyong 
Park, Dae-Hyeon 
Hawi, Stanley 
Kim, Byung-Jo 

Abstract

OBJECT Brain deformation can be seen in hydrocephalus and idiopathic intracranial hypertension (IIH) via medical images. The phenomenology of local effects, brain shift, and raised intracranial pressure and herniation are textbook concepts. However, there are still uncertainties regarding the specific processes that occur when brain tissue is subject to the mechanical stress of different temporal and spatial profiles of the 2 neurological disorders. Moreover, recent studies suggest that IIH and hydrocephalus may be diseases with opposite pathogenesis. Nevertheless, the similarities and differences between the 2 subjects have not been thoroughly investigated. METHODS An anatomical porohyperelastic finite element model was used to assess the brain tissue responses associated with hydrocephalus and IIH. The same set of boundary conditions, with the exception of brain loading for development of the transmantle pressure gradient, was applied for the 2 models. The distribution of stress and strain during tissue distortion is described by the mechanical parameters. RESULTS The results of both the hydrocephalus and IIH models correlated with pathological characteristics. For the hydrocephalus model, periventricular edema was associated with the presence of positive volumetric strain and void ratio in the lateral ventricle horns. By contrast, the IIH model revealed edema across the cerebral mantle, including the centrum semiovale, with a positive void ratio and volumetric strain. CONCLUSIONS The model simulates all the clinical features in correlation with the MR images obtained in patients with hydrocephalus and IIH, thus providing support for the role of the transmantle pressure gradient and capillary CSF absorption in CSF-related brain deformation. The finite element methods can be used for a better understanding of the pathophysiological mechanisms of neurological disorders associated with parenchymal volumetric fluctuation.

Description

This is the accepted manuscript of a paper published in the Journal of Neurosurgery, Published online February 6, 2015; DOI: 10.3171/2014.12.JNS14516.

Keywords

biomechanics, bi-phase, finite element model, hydrocephalus, idiopathic, intracranial hypertension, cerebrospinal fluid

Journal Title

Journal of Neurosurgery

Conference Name

Journal ISSN

Volume Title

122

Publisher

American Association of Neurological Surgeons
Sponsorship
Dr. M. Czosnyka is a consultant for J&J (Codman), and has received payment for lectures from Integra Lifescience. This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRFK) funded by the Ministry of Science, ICT, & Future Planning (2013R1A1A1004827); and the International Research & Development Program of the NRFK funded by the Ministry of Education, Science, and Technology of Korea (Grant No. 2014K1A3A1A21001366).