Impact of CCSVI on cerebral haemodynamics: a mathematical study using MRI angiographic and flow data
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BACKGROUND: The presence of abnormal anatomy and flow in neck veins has been recently linked to neurological diseases. The precise impact of extra-cranial abnormalities such as stenoses remains unexplored. METHODS: Pressure and velocity fields in the full cardiovascular system are computed by means of a global mathematical model that accounts for the relationship between pulsating cerebral blood flow and intracranial pressure. RESULTS: Our model predicts that extra-cranial strictures cause increased pressure in the cerebral venous system. Specifically, there is a predicted pressure increase of about 10% in patients with a 90% stenoses. Pressure increases are related to significant flow redistribution with flow reduction of up to 70% in stenosed vessels and consequent flow increase in collateral pathways. CONCLUSIONS: Extra-cranial venous strictures can lead to pressure increases in intra-cranial veins of up to 1.3 mmHg, despite the shielding role of the Starling resistor. The long-term clinical implications of the predicted pressure changes are unclear.
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