Abstract
This study investigates the mechanics of normal pressure hydrocephalus
(NPH) growth using a computational approach. We created a generic
3-D brain mesh of a healthy human brain and modelled the brain parenchyma
as single phase and biphasic continuum. In our model, hyperelastic
constitutive law and finite deformation theory described deformations
within the brain parenchyma. We used a value of 155.77�Pa for the
shear modulus (mu) of the brain parenchyma. Additionally, in our
model, contact boundary definitions constrained the brain outer surface
inside the skull. We used transmantle pressure difference to load
the model. Fully nonlinear, implicit finite element procedures in
the time domain were used to obtain the deformations of the ventricles
and the brain. To the best of our knowledge, this was the first 3-D,
fully nonlinear model investigating NPH growth mechanics. Clinicians
generally accept that at most 1�mm of Hg transmantle pressure difference
(133.416�Pa) is associated with the condition of NPH. Our computations
showed that transmantle pressure difference of 1�mm of Hg (133.416�Pa)
did not produce NPH for either single phase or biphasic model of
the brain parenchyma. A minimum transmantle pressure difference of
1.764�mm of Hg (235.44�Pa) was required to produce the clinical condition
of NPH. This suggested that the hypothesis of a purely mechanical
basis for NPH growth needs to be revised. We also showed that under
equal transmantle pressure difference load, there were no significant
differences between the computed ventricular volumes for biphasic
and incompressible/nearly incompressible single phase model of the
brain parenchyma. As a result, there was no major advantage gained
by using a biphasic model for the brain parenchyma. We propose that
for modelling NPH, nearly incompressible single phase model of the
brain parenchyma was adequate. Single phase treatment of the brain
parenchyma simplified the mathematical description of the NPH model
and resulted in significant reduction of computational time.
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