Normal 0 false false false EN-US X-NONE AR-SA
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CSF spaces comprise all intracerebral ventricles,
spinal and brain subarachnoid spaces,
such as cisterns and sulci,
and the central canal of the spinal cord. Research of CSF flow and its disorders began as early as 1913 by Dr.
Walter Dandy of John Hopkins university.[1] First by experimental animals studies and then in 1919 more studies as pneumoventriculography yielded more information about CSF pathways and its abnormalities.
Multiple congenital and acquired disorders can alter CSF flow dynamics and resulting in hydrocephalus.
The Dandy traditional classification of hydrocephalus still forms the basis of classification system used at this time.
It includes:
• Communicating hydrocephalus: hydrocephalus with obstructive cisternal membrane only without accompanying intraventricular or fourth ventricular exit foramina obstruction.
• Non communicating : Intraventricular membranous obstruction: The membranous obstruction at the foramen of Monro,
the cerebral aqueduct,
foramen of Magendie,
foramina of Luschka,
and superior medullary velum.
The international classification of diseases,
ninth revision codes for hydrocephalus use the same words in Dandy's classification plus the new addition of idiopathic normal pressure hydrocephalus as a third category.[2]
Types of CSF flow:
· Pulsatile: a cyclic back and forth flows during every cardiac cycle.
During systole,
there is increased cerebral blood flow leading to brain tissue expansion and forcing caudal movement of CSF.
While during diastole,
decreased cerebral blood flow and associated brain tissue regression permits cranial movement of CSF.
Average peak velocity of 5cm/sec.
· Bulk: Slow molecular motion by effect of gravity and Brownian motions.
Average velocity of 0.2cm/sec.
· Reflux: turbulent back flow of CSF from the aqueduct to the third ventricle and from the third ventricle to the lateral ventricles.[3]
We aim to present a state of art imaging of CSF flow disorders and variants by combining high resolution anatomical images as 3D -constructive interference in steady state (3D-CISS) and CSF flow-sensitive imaging in correlation with clinical usefulness.