EXPERIMENTAL AND NUMERICAL MODELLING OF THE VENTRICULO-SINUS SHUNT TO TREAT MALRESOPTIVE HYDROCEPHALUS

摘要

This study assesses malresorptive hydrocephalus treatment by ventriculosinus (VS) shunting with the shunt in antegrade or retrograde position. First, an experimental model of the cerebral ventricles, the arachnoid villi, the cortical veins and the superior sagittal sinus (SSS) was built. For this purpose, the compliance of a human cortical vein was measured ex vivo and then modelled by means of Penrose tubes. The dimensions of the superior sagittal sinus were also determined in vivo by measurements on MRI-scans of 21 patients. Secondly, with the experimental model, a numerical model of the cortical veins and the superior sagittal sinus was validated. The experimental and numerical pressure difference between the intracranial pressure and the static sinus pressure was small (0-20 Pa) and corresponded with the theoretically expected values. No overdrainage was found in either antegrade or retrograde position of the shunt. Blood reflow was only found while mimicking lumbar puncture or changes in position with the experimental model (fast lowering the intracranial pressure respectively fast increasing the sinus pressure). Both model results confirm the potential of ventriculosinus shunting as therapy for malresorptive hydrocephalus patients. The ventriculosinus shunt thus proves to be a promising technique.