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Keywords = neurofluids

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20 pages, 13210 KiB  
Review
Overview of the Current Knowledge and Conventional MRI Characteristics of Peri- and Para-Vascular Spaces
by Marco Parillo, Federica Vaccarino, Gianfranco Di Gennaro, Sumeet Kumar, Johan Van Goethem, Bruno Beomonte Zobel, Carlo Cosimo Quattrocchi, Paul M. Parizel and Carlo Augusto Mallio
Brain Sci. 2024, 14(2), 138; https://doi.org/10.3390/brainsci14020138 - 28 Jan 2024
Cited by 6 | Viewed by 3968
Abstract
Brain spaces around (perivascular spaces) and alongside (paravascular or Virchow–Robin spaces) vessels have gained significant attention in recent years due to the advancements of in vivo imaging tools and to their crucial role in maintaining brain health, contributing to the anatomic foundation of [...] Read more.
Brain spaces around (perivascular spaces) and alongside (paravascular or Virchow–Robin spaces) vessels have gained significant attention in recent years due to the advancements of in vivo imaging tools and to their crucial role in maintaining brain health, contributing to the anatomic foundation of the glymphatic system. In fact, it is widely accepted that peri- and para-vascular spaces function as waste clearance pathways for the brain for materials such as ß-amyloid by allowing exchange between cerebrospinal fluid and interstitial fluid. Visible brain spaces on magnetic resonance imaging are often a normal finding, but they have also been associated with a wide range of neurological and systemic conditions, suggesting their potential as early indicators of intracranial pressure and neurofluid imbalance. Nonetheless, several aspects of these spaces are still controversial. This article offers an overview of the current knowledge and magnetic resonance imaging characteristics of peri- and para-vascular spaces, which can help in daily clinical practice image description and interpretation. This paper is organized into different sections, including the microscopic anatomy of peri- and para-vascular spaces, their associations with pathological and physiological events, and their differential diagnosis. Full article
(This article belongs to the Special Issue Pushing the Boundaries of Neuroradiology: Cutting-Edge Advanced Applications and Innovations)
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12 pages, 2553 KiB  
Article
Hemodynamic and Hydrodynamic Pathophysiology in Chiari Type 1 Malformations: Towards Understanding the Genesis of Syrinx
by Cyrille Capel, Romaric Lantonkpode, Serge Metanbou, Johann Peltier and Olivier Balédent
J. Clin. Med. 2023, 12(18), 5954; https://doi.org/10.3390/jcm12185954 - 13 Sep 2023
Cited by 4 | Viewed by 1563
Abstract
Background: The pathophysiology of this association of type 1 Chiari malformation (CM1) and syrinxes is still unknown. There is an alteration in the dynamics of neurofluids (cerebrospinal fluid, arterial and venous blood) during the cardiac cycle in CM1. Our objective is to quantify [...] Read more.
Background: The pathophysiology of this association of type 1 Chiari malformation (CM1) and syrinxes is still unknown. There is an alteration in the dynamics of neurofluids (cerebrospinal fluid, arterial and venous blood) during the cardiac cycle in CM1. Our objective is to quantify CSF or arterial blood or venous blood flow in patients with Chiari syndrome (CS) with and without syrinxes using phase-contrast MRI (PCMRI). Methods: We included 28 patients with CM1 (9 with syrinxes, 19 without). Morphological MRI with complementary PCMRI sequences was performed. We analyzed intraventricular CSF, subarachnoid spaces CSF, blood, and tonsillar pulsatility. Results: There is a highly significant correlation (p < 0.001) between cerebral blood flow, cerebral vascular expansion volume and venous drainage distribution. Venous drainage distribution is significantly inversely correlated with oscillatory CSF volume at the level of the foramen magnum plane [−0.37 (0.04)] and not significantly correlated at the C2C3 level [−0.37 (0.05)] over our entire population. This correlation maintained the same trend in patients with syrinxes [−0.80 (<0.01)] and disappeared in patients without a syrinx [−0.05 (0.81)]. Conclusion: The distribution of venous drainage is an important factor in intracranial homeostasis. Impaired venous drainage would lead to greater involvement of the CSF in compensating for arterial blood influx, thus contributing to syrinx genesis. Full article
(This article belongs to the Special Issue Chiari 1 Malformation, Syringomyelia and Related Disorders: Advances in Diagnosis and Treatment for Adults and Children)
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11 pages, 925 KiB  
Article
Insights on the Hydrodynamics of Chiari Malformation
by Cyrille Capel, Pauline Padovani, Pierre-Henri Launois, Serge Metanbou, Olivier Balédent and Johann Peltier
J. Clin. Med. 2022, 11(18), 5343; https://doi.org/10.3390/jcm11185343 - 12 Sep 2022
Cited by 14 | Viewed by 2960
Abstract
Background: We propose that the appearance of a ptosis of the cerebellar tonsils and syringomyelia is linked to its own hemohydrodynamic mechanisms. We aimed to quantify cerebrospinal fluid (CSF) and cerebral blood flow to highlight how neurofluid is affected by Chiari malformations type [...] Read more.
Background: We propose that the appearance of a ptosis of the cerebellar tonsils and syringomyelia is linked to its own hemohydrodynamic mechanisms. We aimed to quantify cerebrospinal fluid (CSF) and cerebral blood flow to highlight how neurofluid is affected by Chiari malformations type 1(CMI) and its surgery. Methods: We retrospectively included 21 adult patients with CMI who underwent pre- and postoperative phase contrast MRI (PCMRI) during the period from 2001 to 2017. We analyzed intraventricular CSF, subarachnoid spaces CSF, blood, and tonsils pulsatilities. Results: In preoperative period, jugular venous drainage seems to be less preponderant in patients with syringomyelia than other patients (venous correction factor: 1.49 ± 0.4 vs. 1.19 ± 0.1, p = 0.05). After surgery, tonsils pulsatility decreased significantly (323 ± 175 μL/cardiac cycle (CC) vs. 194 ± 130 μL/CC, p = 0.008) and subarachnoid CSF pulsatility at the foramen magnum increased significantly (201 ± 124 μL/CC vs. 363 ± 231 μL/CC, p = 0.02). After surgery, we found a decrease in venous flow amplitude (5578 ± 2469 mm3/s vs. 4576 ± 2084 mm3/s, p = 0.008) and venous correction factor (1.98 ± 0.3 vs. 1.20 ± 0.3 mm3/s, p = 0.004). Conclusions: Phase-contrast MRI could be a useful additional tool for postoperative evaluation and follow-up, and is complementary to morphological imaging. Full article
(This article belongs to the Special Issue Chiari 1 Malformation, Syringomyelia and Related Disorders: Advances in Diagnosis and Treatment for Adults and Children)
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