Intracranial volumetric changes govern cerebrospinal fluid flow in the Aqueduct of Sylvius in healthy adults

Abstract

Purpose

To characterize the intracranial volumetric changes that influence the cerebrospinal fluid (CSF) pulse in the Aqueduct of Sylvius (AoS).

Materials and methods

Neck MRI data were acquired from 12 healthy adults (8 female and 4 males; mean age = 30.9 years), using a 1.5 T scanner. The intracranial arterial, venous and CSF volumes changes, together with the aqueductal CSF (aCSF) volume, were estimated from flow rate data acquired at C2/C3 level and in the AoS. The correlations and temporal relationships among these volumes were computed.

Results

The aCSF volumetric changes were strongly correlated (r = 0.967, p < 0.001) with the changes in intracranial venous volume, whose peak occurred 7.0% of cardiac cycle (p = 0.023) before peak aCSF volume, but less correlated with the intracranial arterial and CSF volume changes (r = −0.664 and 0.676 respectively, p < 0.001). The intracranial CSF volume change was correlated with the intracranial venous volume change (r = 0.820, p < 0.001), whose peak occurred slightly before (4.2% of CC, p = 0.059).

Conclusion

The aCSF pulse is strongly correlated with intracranial venous volume, with expansion of the cortical veins occurring prior to aCSF flow towards the third ventricle. Both caudal-cranial aCSF flow and venous blood retention occur when arterial blood volume is at a minimum.