Title:Cerebrospinal Fluid CSF Flow Artifacts are Associated with Brain
Pulsation in Patients with Severe Carotid Artery Stenoses
Volume: 19
Issue: 3
Author(s): Toshio Imaizumi*, Tatsufumi Nomura, Shoichi Komura, Shigeru Inamura, Tomoaki Tamada, Aya Kanno and Tadashi Nonaka
Affiliation:
- Department of Neurosurgery, Kushiro City General Hospital, 1-12 Shunkodai, Kushiro, Hokkaido 085-0822, Japan
Keywords:
Brain pulsation, cerebrospinal fluid, cerebral blood flow, carotid artery stenosis, brain atrophy, risk factor.
Abstract: Objective: We investigated the factors associated with cerebrospinal fluid (CSF) flow
artifacts on fluid-attenuated inversion recovery imaging in patients with carotid artery (CA) stenosis.
Methods: Each CSF artifact grade was defined by comparing the highest intensity in a given region
of interest (ROI) to those in reference ROIs, as follows: higher than the intensity of normal white
matter in the centrum semiovale = 2 points; equal to or less than the white matter, and higher than
CSF = 1 point; and equal to CSF = 0. CSF flow scores in eight sites were measured and added to the
total score (0 -16). The prevalences of each finding, specifically white matter lesions, CA stenoses
and brain atrophy, were compared using multivariate logistic regression models.
Results: We evaluated the findings in 54 patients with CA stenosis treated by CA stenting (CAS)
and 200 adults with no history of neurological disorders (control group). Adjusted by stroke risk
factors, a CSF flow score ≤ 11 was positively associated with CA stenosis, heart rate > 70 / min, and
brain atrophy, and negatively with the female gender. The score was 12.8 ± 1.8 in the control group
and 12.0 ± 2.0 in CA stenosis group after CAS, which was significantly higher than before CAS
(10.4 ± 2.8, p<0.001).
Conclusion: The CSF flow score was associated with female gender, brain atrophy, heart rate, and
severe CA stenosis, and was found to be elevated after revascularization.
