Post-cranioplasty cerebrospinal fluid hydrodynamic changes: Magnetic resonance imaging quantitative analysis

• Published in: Neurological research (New York) 1997-06, Vol.19 (3), p.311-316
• Main Authors: Dujovny, M., Fernandez, P., Alperin, N., Betz, W., Misra, Mukesh, Mafee, M.
• Format: Article
• Language: English
• Subjects: Adult; Blood Flow Velocity; Bone Plates; Central Nervous System - blood supply; Central Nervous System - metabolism; Cerebrospinal Fluid - metabolism; Cerebrospinal fluid dynamic; Cerebrospinal Fluid Pressure; Cerebrovascular Circulation; Cine phase-contrast magnetic resonance imaging; Cranioplasty; Craniotomy; Frontal Bone - pathology; Frontal Bone - surgery; Heart - physiology; Humans; Magnetic Resonance Imaging, Cine - methods; Male; Pulsatile Flow; Spinal Canal - blood supply; Spinal Canal - metabolism
• ISSN: 0161-6412; 1743-1328
• DOI: 10.1080/01616412.1997.11740818

The syndrome ofthe trephined has been described in many patients with cranial defects as an indication for cranioplasty. Cerebral blood flow changes, the effect of the atmospheric pressure on the brain, as well as cerebrospinal fluid hydrodynamic changes have been postulated as the possible reasons for this syndrome. Using dynamic phase-contrast magnetic resonance imaging -we measured arteria II venous, and cerebrospinal fluid flow into and out of the skull, before and after cranioplasty in one patient whose bone flap was removed because of osteomyelitis. We report significant changes in the oscilla.tory CSF flow after. cranioplasty. A moderate increase in venous outflow as well as a two-fold increase in craniocaudal cerebrospinal fluid systolic flow velocity was measured after the skull closure. The changes in the cerebrospinal fluid oscillatory flow at the level of the eraniovertebraIjunction could reflect changes in the compliance of the craniospinal system produced by closure of the cranial defect. [Neural Res 1997; 19: 311-316]