Modelling midline shift and ventricle collapse in cerebral oedema following acute ischaemic stroke
In ischaemic stroke, a large reduction in blood supply can lead to the breakdown of the blood-brain barrier and to cerebral oedema after reperfusion therapy. The resulting fluid accumulation in the brain may contribute to a significant rise in intracranial pressure (ICP) and tissue deformation. Chan...
| Main Authors: | , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
Public Library of Science
2024
|
| _version_ | 1826313203003424768 |
|---|---|
| author | Chen, X Józsa, TI Cardim, D Robba, C Czosnyka, M Payne, SJ |
| author_facet | Chen, X Józsa, TI Cardim, D Robba, C Czosnyka, M Payne, SJ |
| author_sort | Chen, X |
| collection | OXFORD |
| description | In ischaemic stroke, a large reduction in blood supply can lead to the breakdown of the blood-brain barrier and to cerebral oedema after reperfusion therapy. The resulting fluid accumulation in the brain may contribute to a significant rise in intracranial pressure (ICP) and tissue deformation. Changes in the level of ICP are essential for clinical decision-making and therapeutic strategies. However, the measurement of ICP is constrained by clinical techniques and obtaining the exact values of the ICP has proven challenging. In this study, we propose the first computational model for the simulation of cerebral oedema following acute ischaemic stroke for the investigation of ICP and midline shift (MLS) relationship. The model consists of three components for the simulation of healthy blood flow, occluded blood flow and oedema, respectively. The healthy and occluded blood flow components are utilized to obtain oedema core geometry and then imported into the oedema model for the simulation of oedema growth. The simulation results of the model are compared with clinical data from 97 traumatic brain injury patients for the validation of major model parameters. Midline shift has been widely used for the diagnosis, clinical decision-making, and prognosis of oedema patients. Therefore, we focus on quantifying the relationship between ICP and midline shift (MLS) and identify the factors that can affect the ICP-MLS relationship. Three major factors are investigated, including the brain geometry, blood-brain barrier damage severity and the types of oedema (including rare types of oedema). Meanwhile, the two major types (stress and tension/compression) of mechanical brain damage are also presented and the differences in the stress, tension, and compression between the intraparenchymal and periventricular regions are discussed. This work helps to predict ICP precisely and therefore provides improved clinical guidance for the treatment of brain oedema. |
| first_indexed | 2024-09-25T04:09:25Z |
| format | Journal article |
| id | oxford-uuid:bd676ee2-1c5b-42f5-9cf8-0db306740682 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-09-25T04:09:25Z |
| publishDate | 2024 |
| publisher | Public Library of Science |
| record_format | dspace |
| spelling | oxford-uuid:bd676ee2-1c5b-42f5-9cf8-0db3067406822024-06-08T20:04:49ZModelling midline shift and ventricle collapse in cerebral oedema following acute ischaemic strokeJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:bd676ee2-1c5b-42f5-9cf8-0db306740682EnglishJisc Publications RouterPublic Library of Science2024Chen, XJózsa, TICardim, DRobba, CCzosnyka, MPayne, SJIn ischaemic stroke, a large reduction in blood supply can lead to the breakdown of the blood-brain barrier and to cerebral oedema after reperfusion therapy. The resulting fluid accumulation in the brain may contribute to a significant rise in intracranial pressure (ICP) and tissue deformation. Changes in the level of ICP are essential for clinical decision-making and therapeutic strategies. However, the measurement of ICP is constrained by clinical techniques and obtaining the exact values of the ICP has proven challenging. In this study, we propose the first computational model for the simulation of cerebral oedema following acute ischaemic stroke for the investigation of ICP and midline shift (MLS) relationship. The model consists of three components for the simulation of healthy blood flow, occluded blood flow and oedema, respectively. The healthy and occluded blood flow components are utilized to obtain oedema core geometry and then imported into the oedema model for the simulation of oedema growth. The simulation results of the model are compared with clinical data from 97 traumatic brain injury patients for the validation of major model parameters. Midline shift has been widely used for the diagnosis, clinical decision-making, and prognosis of oedema patients. Therefore, we focus on quantifying the relationship between ICP and midline shift (MLS) and identify the factors that can affect the ICP-MLS relationship. Three major factors are investigated, including the brain geometry, blood-brain barrier damage severity and the types of oedema (including rare types of oedema). Meanwhile, the two major types (stress and tension/compression) of mechanical brain damage are also presented and the differences in the stress, tension, and compression between the intraparenchymal and periventricular regions are discussed. This work helps to predict ICP precisely and therefore provides improved clinical guidance for the treatment of brain oedema. |
| spellingShingle | Chen, X Józsa, TI Cardim, D Robba, C Czosnyka, M Payne, SJ Modelling midline shift and ventricle collapse in cerebral oedema following acute ischaemic stroke |
| title | Modelling midline shift and ventricle collapse in cerebral oedema following acute ischaemic stroke |
| title_full | Modelling midline shift and ventricle collapse in cerebral oedema following acute ischaemic stroke |
| title_fullStr | Modelling midline shift and ventricle collapse in cerebral oedema following acute ischaemic stroke |
| title_full_unstemmed | Modelling midline shift and ventricle collapse in cerebral oedema following acute ischaemic stroke |
| title_short | Modelling midline shift and ventricle collapse in cerebral oedema following acute ischaemic stroke |
| title_sort | modelling midline shift and ventricle collapse in cerebral oedema following acute ischaemic stroke |
| work_keys_str_mv | AT chenx modellingmidlineshiftandventriclecollapseincerebraloedemafollowingacuteischaemicstroke AT jozsati modellingmidlineshiftandventriclecollapseincerebraloedemafollowingacuteischaemicstroke AT cardimd modellingmidlineshiftandventriclecollapseincerebraloedemafollowingacuteischaemicstroke AT robbac modellingmidlineshiftandventriclecollapseincerebraloedemafollowingacuteischaemicstroke AT czosnykam modellingmidlineshiftandventriclecollapseincerebraloedemafollowingacuteischaemicstroke AT paynesj modellingmidlineshiftandventriclecollapseincerebraloedemafollowingacuteischaemicstroke |