A Mathematical Investigation of the Role of Intracranial Pressure Pulsations and Small Gradients in the Pathogenesis of Hydrocephalus.

Cerebrospinal fluid (CSF) pulsations have been proposed as a possible causative mechanism for the ventricular enlargement that characterizes the neurological condition known as hydrocephalus. This paper summarizes recent work by the authors to anaylze the effect of CSF pulsations on brain tissue to determine if they are mechanically capable of enlarging the cerebral ventricles. First a poroelastic model is presented to analyze the interactions that occur between the fluid and porous solid constituents of brain tissue due to CSF pulsations. A viscoelastic model is then presented to analyze the effects of the fluid pulsations on the solid brain tissue. The combined results indicate that CSF pulsations in a healthy brain are incapable of causing tissue damage and thus the ventricular enlargement observed in hydrocephalus. Therefore they cannot be the primary cause of this condition. Finally, a hyper-viscoelastic model is presented and used to demonstrate that small long-term transmantle pressure gradients may be a possible cause of communicating hydrocephalus in infants.