Craniospinal compliance studied by PC-MRI and intracranial pressure measurement in hydrocephalus patients

Motivation: Craniospinal compliance is known to be altered in normal pressure hydrocephalus (NPH) patients, yet reliable measurement methods are lacking. Standard techniques measure compliance under conditions of volume and time differing from patients' normal physiological states. Goal(s): To propose a new method for estimating craniospinal compliance in NPH patients. Approach: In 27 NPH patients, neurofluids volume change and intracranial pressure pulse over one cardiac cycle were calculated by PC-MRI and infusion tests to estimate physiological compliance, then compared with infusion-based compliance. Results: Infusion-based compliances were significantly higher than physiological compliances, with a moderate correlation between the two measurements. Impact: This study introduces a novel method for estimating craniospinal compliance under physiological conditions, prompting new questions on how compliance adapts to changes in time, volume and pressure. These insights may enhance diagnostic accuracy and lead to better-targeted NPH interventions.