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A Coupled Lumped-Parameter and Distributed Network Model for Cerebral Pulse-Wave Hemodynamics

机译:脑脉冲波血流动力学的集总参数和分布式网络耦合模型

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摘要

The cerebral circulation is unique in its ability to maintain blood flow to the brain under widely varying physiologic conditions. Incorporating this autoregulatory response is necessary for cerebral blood flow (CBF) modeling, as well as investigations into pathological conditions. We discuss a one-dimensional (1D) nonlinear model of blood flow in the cerebral arteries coupled to autoregulatory lumped-parameter (LP) networks. The LP networks incorporate intracranial pressure (ICP), cerebrospinal fluid (CSF), and cortical collateral blood flow models. The overall model is used to evaluate changes in CBF due to occlusions in the middle cerebral artery (MCA) and common carotid artery (CCA). Velocity waveforms at the CCA and internal carotid artery (ICA) were examined prior and post MCA occlusion. Evident waveform changes due to the occlusion were observed, providing insight into cerebral vasospasm monitoring by morphological changes of the velocity or pressure waveforms. The role of modeling of collateral blood flows through cortical pathways and communicating arteries was also studied. When the MCA was occluded, the cortical collateral flow had an important compensatory role, whereas the communicating arteries in the circle of Willis (CoW) became more important when the CCA was occluded. To validate the model, simulations were conducted to reproduce a clinical test to assess dynamic autoregulatory function, and results demonstrated agreement with published measurements.
机译:脑循环在保持生理状态广泛变化的情况下能够维持流向大脑的血液的能力是独一无二的。纳入这种自动调节反应对于脑血流量(CBF)建模以及对病理状况的研究是必要的。我们讨论与自调节集总参数(LP)网络耦合的脑动脉血流的一维(1D)非线性模型。 LP网络包含颅内压(ICP),脑脊液(CSF)和皮质侧支血流模型。整体模型用于评估由于大脑中动脉(MCA)和颈总动脉(CCA)阻塞而引起的CBF变化。在MCA闭塞前后,检查CCA和颈内动脉(ICA)的速度波形。观察到由于闭塞引起的明显波形变化,从而通过速度或压力波形的形态变化提供了对脑血管痉挛监测的见识。还研究了通过皮质途径和动脉连通的侧支血流建模的作用。当闭塞MCA时,皮质侧支血流起着重要的补偿作用,而闭塞CCA时,威利斯(CoW)圈内的交流动脉变得更加重要。为了验证该模型,进行了仿真以重现临床测试以评估动态自动调节功能,并证明结果与已发布的测量结果一致。

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