A Mathematical Model for Simulating Cerebrospinal Fluid Hydrodynamics According to the Extended Monro–Kellie–(Burrows–Weed) Doctrine

Description

Abstract (English)

A mathematical model and simulations of physiological and pathological cerebrospinal fluid (CSF) hydrodynamics are presented based on the hypothesis “The Intracraniovertebral Volumes, the Cerebrospinal Fluid Flow, and the Cerebrospinal Fluid Pressure, Their Homeostasis and Its Physical Regulation”. The model incorporates the extended Monro–Kellie–(Burrows–Weed) doctrine, which includes all components contained within the near–fixed-volume intracraniospinal compartment. Using parameters derived from known experimental and clinical data, the model simulates CSF formation, removal, flow, and volume across physiological and pathological ranges of intracranial pressure (ICP). The results demonstrate the existence of a physiological homeostatic phase governed by negative ICP feedback and pathological phases governed by positive feedback, leading to compensated and de-compensated states. The model further enables simulations under altered CSF formation and removal conditions, including obstructive scenarios, revealing characteristic profiles of hypertension, hypotension, hypervolemia, hypovolemia, and absent CSF flow. These simulations highlight the need for simultaneous measurement of ICP, CSF volume, and CSF flow in clinical diagnostics and contribute to a deeper understanding of CSF hydrodynamics and the so-called “third circulation.