Quantitative Analysis of Blood Flow in Cerebral Venous Sinus With Stenosis by Patient-Specific CFD Modeling

Abstract

Hemodynamics analysis of the cerebral venous sinus (CVS) is important to the etiologies of idiopathic intracranial hypertension (IIH) and pulsatile tinnitus (PT). However, the underlying mechanism of the hemodynamics contributing to IIH and PT is still unclear. The aim of this paper is to investigate the hemodynamics of the patient-specific CVS with stenosis by using a computational fluid dynamics analysis. Hemodynamics under the circumstances of different body positions, such as supine, upright, left lateral, and right lateral, was further evaluated for more comprehensive understanding of the impacts of CVS stenosis. Three cases were involved and the patient-specific hemodynamics analysis was performed. Our results showed that the effect of CVS stenosis was dependent on the drainage dominance. CVS stenosis in the collateral branch to the drainage dominance vessel showed a limited effect on the acceleration of blood flow (T1, 163.64%), while a significant increase of velocity was observed in the balance drainage dominance cases (T2, 281.25%). Moreover, body position could be a trigger to the IIH. Our results indicated that the pressure gradient in the CVS shifted along with a different body position. Especially, the average pressure of the CVS increased by 22%, 123.8%, and 45.2% in T1, T2, and T3, respectively, comparing upright position to supine position. Finally, the proposed patient-specific hemodynamics analysis method could reproduce physiological hemodynamics in CVS. The result of this paper could potentially provide further understanding of IIH-related headache and PT.

Keywords

• Cerebral venous sinus
• stenosis
• computational fluid dynamics
• blood flow
• body position