POST-CRANIOPLASTY CEREBROSPINAL-FLUID HYDRODYNAMIC CHANGES - MAGNETIC-RESONANCE-IMAGING QUANTITATIVE-ANALYSIS

The syndrome of the trephined has been described in many patients with cranial defects as an indication for cranioplasty. Cerebral blood Now changes, the effect of the atmospheric pressure on the brain, as well as cerebrospinal fluid hydrodynamic changes have been postulated as t he possible reasons for this syndrome. Using dynamic phase-contrast ma gnetic resonance imaging we measured arterial, venous, and cerebrospin al fluid Now into and out oi the skull, before and after cranioplasty in one patient whose bone nap was removed because of osteomyelitis. We report significant changes in the oscillatory CSF Now after craniopla sty. A moderate increase in venous outflow as well as a two-fold incre ase in craniocaudal cerebrospinal fluid systolic Now velocity was meas ured after the skull closure. The changes in the cerebrospinal fluid o scillatory Now at the level of the craniovertebral junction could refl ect changes in the compliance of the craniospinal system produced by c losure of the cranial defect.