Impact of CCSVI on cerebral haemodynamics: a mathematical study using MRI angiographic and flow data

Phlebology. 2016 Jun;31(5):305-24. doi: 10.1177/0268355515586526. Epub 2015 Jun 2.

Abstract

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.

Keywords: CCSVI; MRI-derived patient-specific venous network; cerebral venous hypertension; global mathematical model; human circulation.

MeSH terms

  • Cerebrovascular Circulation*
  • Female
  • Humans
  • Magnetic Resonance Angiography*
  • Male
  • Models, Cardiovascular*
  • Vascular Malformations* / diagnostic imaging
  • Vascular Malformations* / physiopathology