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    Association Between Resistance to Cerebrospinal Fluid Flow Near the Foramen Magnum and Cough-Associated Headache in Adult Chiari Malformation Type I

    Source: Journal of Biomechanical Engineering:;2021:;volume( 143 ):;issue: 005::page 051003-1
    Author:
    Ibrahimy, Alaaddin
    ,
    Huang, Chi-Wen Christina
    ,
    Bezuidenhout, Abraham F.
    ,
    Allen, Philip A.
    ,
    Bhadelia, Rafeeque A.
    ,
    Loth, Francis
    DOI: 10.1115/1.4049788
    Publisher: The American Society of Mechanical Engineers (ASME)
    Abstract: Cough-associated headaches (CAHs) are thought to be distinctive for Chiari malformation type I (CMI) patients and have been shown to be related to the motion of cerebrospinal fluid (CSF) near the foramen magnum (FM). We used computational fluid dynamics (CFD) to compute patient-specific resistance to CSF motion in the spinal canal for CMI patients to determine its accuracy in predicting CAH. Fifty-one symptomatic CMI patients with cerebellar tonsillar position (CTP) ≥ 5 mm were included in this study. The patients were divided into two groups based on their symptoms (CAH and non-CAH) by review of the neurosurgical records. CFD was utilized to simulate CSF motion, and the integrated longitudinal impedance (ILI) was calculated for all patients. A receiver operating characteristic (ROC) curve was evaluated for its accuracy in predicting CAH. The ILI for CMI patients with CAH (776 dyn/cm5, 288—1444 dyn/cm5; median, interquartile range) was significantly larger compared to non-CAH (285 dyn/cm5, 187–450 dyn/cm5; p = 0.001). The ILI was more accurate in predicting CAH in CMI patients than the CTP when the comparison was made using the area under the ROC curve (AUC) (0.77 and 0.70, for ILI and CTP, respectively). ILI ≥ 750 dyn/cm5 had a sensitivity of 50% and a specificity of 95% in predicting CAH. ILI is a parameter that is used to assess CSF blockage in the spinal canal and can predict patients with and without CAH with greater accuracy than CTP.
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      Association Between Resistance to Cerebrospinal Fluid Flow Near the Foramen Magnum and Cough-Associated Headache in Adult Chiari Malformation Type I

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    contributor authorIbrahimy, Alaaddin
    contributor authorHuang, Chi-Wen Christina
    contributor authorBezuidenhout, Abraham F.
    contributor authorAllen, Philip A.
    contributor authorBhadelia, Rafeeque A.
    contributor authorLoth, Francis
    date accessioned2022-02-06T05:25:35Z
    date available2022-02-06T05:25:35Z
    date copyright3/4/2021 12:00:00 AM
    date issued2021
    identifier issn0148-0731
    identifier otherbio_143_05_051003.pdf
    identifier urihttp://yetl.yabesh.ir/yetl1/handle/yetl/4278003
    description abstractCough-associated headaches (CAHs) are thought to be distinctive for Chiari malformation type I (CMI) patients and have been shown to be related to the motion of cerebrospinal fluid (CSF) near the foramen magnum (FM). We used computational fluid dynamics (CFD) to compute patient-specific resistance to CSF motion in the spinal canal for CMI patients to determine its accuracy in predicting CAH. Fifty-one symptomatic CMI patients with cerebellar tonsillar position (CTP) ≥ 5 mm were included in this study. The patients were divided into two groups based on their symptoms (CAH and non-CAH) by review of the neurosurgical records. CFD was utilized to simulate CSF motion, and the integrated longitudinal impedance (ILI) was calculated for all patients. A receiver operating characteristic (ROC) curve was evaluated for its accuracy in predicting CAH. The ILI for CMI patients with CAH (776 dyn/cm5, 288—1444 dyn/cm5; median, interquartile range) was significantly larger compared to non-CAH (285 dyn/cm5, 187–450 dyn/cm5; p = 0.001). The ILI was more accurate in predicting CAH in CMI patients than the CTP when the comparison was made using the area under the ROC curve (AUC) (0.77 and 0.70, for ILI and CTP, respectively). ILI ≥ 750 dyn/cm5 had a sensitivity of 50% and a specificity of 95% in predicting CAH. ILI is a parameter that is used to assess CSF blockage in the spinal canal and can predict patients with and without CAH with greater accuracy than CTP.
    publisherThe American Society of Mechanical Engineers (ASME)
    titleAssociation Between Resistance to Cerebrospinal Fluid Flow Near the Foramen Magnum and Cough-Associated Headache in Adult Chiari Malformation Type I
    typeJournal Paper
    journal volume143
    journal issue5
    journal titleJournal of Biomechanical Engineering
    identifier doi10.1115/1.4049788
    journal fristpage051003-1
    journal lastpage051003-8
    page8
    treeJournal of Biomechanical Engineering:;2021:;volume( 143 ):;issue: 005
    contenttypeFulltext
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