Mathematical modelling of cerebral haemodynamics and their effects on ICP

Introduction: Electrical-equivalence mathematical models that integrate vascular and cerebrospinal fluid (CSF) compartments perform well in simulations of dynamic cerebrovascular variations and their transient effects on intracranial pressure (ICP). However, ICP changes due to sustained vascular dia...

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Main Authors: Ka Hing Chu, Ihsane Olakorede, Erta Beqiri, Marek Czosnyka, Peter Smielewski
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:Brain and Spine
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772529424000286
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author Ka Hing Chu
Ihsane Olakorede
Erta Beqiri
Marek Czosnyka
Peter Smielewski
author_facet Ka Hing Chu
Ihsane Olakorede
Erta Beqiri
Marek Czosnyka
Peter Smielewski
author_sort Ka Hing Chu
collection DOAJ
description Introduction: Electrical-equivalence mathematical models that integrate vascular and cerebrospinal fluid (CSF) compartments perform well in simulations of dynamic cerebrovascular variations and their transient effects on intracranial pressure (ICP). However, ICP changes due to sustained vascular diameter changes have not been comprehensively examined. We hypothesise that changes in cerebrovascular resistance (CVR) alter the resistance of the bulk flow of interstitial fluid (ISF). Research question: We hypothesise that changes in CVR alter the resistance of the bulk flow of ISF, thus allowing simulations of ICP in response to sustained vascular diameter changes. Material and methods: A lumped parameter model with vascular and CSF compartments was constructed and converted into an electrical analogue. The flow and pressure responses to transient hyperaemic response test (THRT) and CSF infusion test (IT) were observed. Arterial blood pressure (ABP) was manipulated to simulate ICP plateau waves. The experiments were repeated with a modified model that included the ISF compartment. Results: Simulations of the THRT produced identical cerebral blood flow (CBF) responses. ICP generated by the new model reacted in a similar manner as the original model during ITs. Plateau pressure reached during ITs was however higher in the ISF model. Only the latter was successful in simulating the onset of ICP plateau waves in response to selective blood pressure manipulations. Discussion and conclusion: Our simulations highlighted the importance of including the ISF compartment, which provides mechanism explaining sustained haemodynamic influences on ICP. Consideration of such interactions enables accurate simulations of the cerebrovascular effects on ICP.
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spelling doaj-art-705f5dc8b7b74cc0a3334cf14e76aca02024-12-15T06:18:13ZengElsevierBrain and Spine2772-52942024-01-014102772Mathematical modelling of cerebral haemodynamics and their effects on ICPKa Hing Chu0Ihsane Olakorede1Erta Beqiri2Marek Czosnyka3Peter Smielewski4Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, UK; Corresponding author. Brain Physics Laboratory, Division of Neurosurgery, Dept of Clinical Neurosciences, University of Cambridge, UK.Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, UKBrain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, UKBrain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, UKBrain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, UKIntroduction: Electrical-equivalence mathematical models that integrate vascular and cerebrospinal fluid (CSF) compartments perform well in simulations of dynamic cerebrovascular variations and their transient effects on intracranial pressure (ICP). However, ICP changes due to sustained vascular diameter changes have not been comprehensively examined. We hypothesise that changes in cerebrovascular resistance (CVR) alter the resistance of the bulk flow of interstitial fluid (ISF). Research question: We hypothesise that changes in CVR alter the resistance of the bulk flow of ISF, thus allowing simulations of ICP in response to sustained vascular diameter changes. Material and methods: A lumped parameter model with vascular and CSF compartments was constructed and converted into an electrical analogue. The flow and pressure responses to transient hyperaemic response test (THRT) and CSF infusion test (IT) were observed. Arterial blood pressure (ABP) was manipulated to simulate ICP plateau waves. The experiments were repeated with a modified model that included the ISF compartment. Results: Simulations of the THRT produced identical cerebral blood flow (CBF) responses. ICP generated by the new model reacted in a similar manner as the original model during ITs. Plateau pressure reached during ITs was however higher in the ISF model. Only the latter was successful in simulating the onset of ICP plateau waves in response to selective blood pressure manipulations. Discussion and conclusion: Our simulations highlighted the importance of including the ISF compartment, which provides mechanism explaining sustained haemodynamic influences on ICP. Consideration of such interactions enables accurate simulations of the cerebrovascular effects on ICP.http://www.sciencedirect.com/science/article/pii/S2772529424000286Mathematical modellingIntracranial pressureCerebral hemodynamicsInterstitial fluid
spellingShingle Ka Hing Chu
Ihsane Olakorede
Erta Beqiri
Marek Czosnyka
Peter Smielewski
Mathematical modelling of cerebral haemodynamics and their effects on ICP
Brain and Spine
Mathematical modelling
Intracranial pressure
Cerebral hemodynamics
Interstitial fluid
title Mathematical modelling of cerebral haemodynamics and their effects on ICP
title_full Mathematical modelling of cerebral haemodynamics and their effects on ICP
title_fullStr Mathematical modelling of cerebral haemodynamics and their effects on ICP
title_full_unstemmed Mathematical modelling of cerebral haemodynamics and their effects on ICP
title_short Mathematical modelling of cerebral haemodynamics and their effects on ICP
title_sort mathematical modelling of cerebral haemodynamics and their effects on icp
topic Mathematical modelling
Intracranial pressure
Cerebral hemodynamics
Interstitial fluid
url http://www.sciencedirect.com/science/article/pii/S2772529424000286
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