Modeling Idiopathic Intracranial Hypertension with a semicollapsible sinus - PowerPoint PPT Presentation

1 / 34
About This Presentation
Title:

Modeling Idiopathic Intracranial Hypertension with a semicollapsible sinus

Description:

Penn State Erie. Idiopathic Intracranial Hypertension (IIH) High pressure (hypertension) ... 2) Demonstrates Pathological ICP wave-forms in IIHWOP ... – PowerPoint PPT presentation

Number of Views:352
Avg rating:3.0/5.0
Slides: 35
Provided by: scottas6
Category:

less

Transcript and Presenter's Notes

Title: Modeling Idiopathic Intracranial Hypertension with a semicollapsible sinus


1
Modeling Idiopathic Intracranial Hypertension
with a semi-collapsible sinus
  • Scott Stevens
  • Penn State Erie

2
Idiopathic Intracranial Hypertension (IIH)
  • High pressure (hypertension)
  • In the head (intracranial)
  • Unknown cause (idiopathic)
  • Symptoms headache, nausea, papilledema (swollen
    optic nerve), visual obscurations possibly
    leading to blindness
  • Often concurrent with intracranial venous-sinus
    stenosis

3
Sinus Stenosis Blockage or compression?
Normal
Stenosed Sinus
  • J N P Higgins, C Cousins, B K Owler, N Sarkies
    and J D Pickard
  • Idiopathic intracranial hypertension 12 cases
    treated by venous sinus stenting
  • Journal of Neurology Neurosurgery and Psychiatry
    2003741662-1666

4
Prevalence
  • IIH prevalence lt 1
  • IIH without papilledema (IIHWOP) ?
  • 6.7 of 724 migraine patients sinus stenosis.
  • 67.8 of these - IIHWOP.
  • Possibly 1.3 million in United States
  • Nine of ten CDH patients IIHWOP with
    Pathological ICP waveforms

Bono 2006, Torbey 2004.
5
Clinically Observed Pathological ICP Waveforms in
IIHWOP
A-waves (plateaus)
B-waves (spikes)
Risberg, Lundberg 1969
Torbey 2004
6
(No Transcript)
7
(No Transcript)
8
(No Transcript)
9
(No Transcript)
10
Model Assumptions
11
Model Assumptions
12
Governing Equations CSF/Brain Compartment
13
Governing Equations Cerebral Veins and Saggital
Sinus
14
Downstream Starling Resistor
Data Heil (1997)
Model
15
Keep your eye on m the initial collapsibility
parameter.
16
Governing Differential Equations
17
Steady-State Equations
18
Options - Bifurcations
19
Bifurcation Diagram for PF in terms of the
collapsibility parameter m
As the collapsibility parameter (m) increases,
the situation gets worse.
20
Limit Cycles Self-excited oscillations
Pathological ICP waveforms
21
Cerebral Blood Flow Perturbations. Spikes and
plateaus together.
22
Post saddle-node bifurcation Similar to our
previous results. Two stable states Normal
and ElevatedTemporary perturbations cause fast,
permanent transitions. Cerebral blood flow
perturbation - Sleep apnea.
23
Potential Diagnostic/Validation Method Bolus
CSF withdrawal.
Collapsible sinus simulation
Rigid sinus simulation
24
Current Endeavors Periodic ForcingGrazing
BifurcationsStochastic influences CBF
autoregulation Single DE system Sigmoidal
Resistor
25
Thanks
  • Jesse Stimpson, Senior, Penn State Erie
  • William D. Lakin, Mathematics, University of
    Vermont
  • Nimish Thakore, Neurology, Case Western Reserve
    University
  • Paul Penar, Neurosurgery, University of Vermont.
  • NASA - NSF

26
Extra Slides
27
A fantastic, web-based direction field / phase
portrait utilityRice University
http//math.rice.edu/dfield/dfpp.html
28
Nullclines in the transformed variables.
29
(No Transcript)
30
  • Previous ModelsIIH characteristics 1) Sinus
    Stenosis2) intermittent symptoms3) long term
    relief4) fast transitions between states5)
    treatment methodsStevens, Previte, Lakin,
    Thakore, Penar, and Hamschin "Idiopathic
    Intracranial Hypertension and Transverse Sinus
    Stenosis A Modeling Study". Mathematical
    Medicine and Biology 2007
  • Current ModelIIHWOP characteristics1) Retains
    previous results for IIH2) Demonstrates
    Pathological ICP wave-forms in
    IIHWOPStevens, Stimpson, Lakin, Thakore, and
    Penar A model for idiopathic intracranial
    hypertension and associated pathological ICP
    wave-forms. Accepted by IEEE Transaction on
    Biomedical Engineering.

31
(No Transcript)
32
(No Transcript)
33
(No Transcript)
34
(No Transcript)
Write a Comment
User Comments (0)
About PowerShow.com