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Stewart, Peter, Brook, Bindi, Jensen, Oliver, Spelman, Tamsin, Whittaker, Robert 
ORCID: https://orcid.org/0000-0001-9598-5938 and Zouache, Moussa
(2024)
Rapid amplification of cerebrospinal fluid pressure as a possible mechanism for optic nerve sheath bleeding in infants with non-accidental head injury.
Investigative Ophthalmology & Visual Science, 65 (12).
ISSN 0146-0404
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Abstract
Purpose: Subdural haemorrhage along the optic nerve (ON) is a histopathological indicator of non-accidental head injury in infants. We sought to determine if this bleeding could be caused by an abrupt increase in intracranial pressure (ICP) transmitted to cerebrospinal fluid (CSF) at the optic foramen (OF). Methods: A theoretical model is developed to simulate the effect of a pressure perturbation of maximal amplitude P applied at the OF for a duration T on the CSF-filled ON subarachnoid space (ONSAS). The ONSAS is modelled as a fluid-filled channel with an elastic wall representing the flexible ONSAS-arachnoid/dura interface. A constitutive law describing the relationship between CSF pressure and ONSAS deformation is inferred from published measurements. CSF pressure profiles along the ONSAS are systematically examined over a broad range of P and T. Results: The pressure perturbation initiated at the OF produces a pressure wave that propagates rapidly along the ONSAS towards the scleral end of the ON, where it is reflected back towards the brain. For sufficiently small T a shock wave with amplification up to six times larger than P over a timescale of tens of milliseconds is observed at the scleral end of the ON. Comparatively smaller amplifications are observed for slower perturbations. Conclusions: A sudden increase in CSF pressure in the cranial cavity can cause a rapid expansion of the ONSAS, which may lead to rupture of the bridging blood vessels. The model therefore predicts a plausible mechanism for subdural haemorrhage that occurs in non-accidental head injury in infants.
| Item Type: | Article |
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| Additional Information: | Data Accessibility: This article has no experimental data. Numerical data for the figures in this paper was generated using MATLAB 2022b and can be accessed at http://dx.doi.org/10.5525/gla.researchdata.1565. Acknowledgments: This work was initiated at the 2014 Mathematics in Medicine Study Group held at Isaac Newton Institute, University of Cambridge, which was funded by the National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs, UK) and the Engineering and Physical Sciences Research Council (UK) POEMS network EP/L001101/1. PSS and TAS acknowledge funding from Engineering and Physical Sciences Research Council (UK) grant EP/P024270/1. PSS acknowledges funding from Engineering and Physical Sciences Research Council (UK) grants EP/N014642/1, EP/S030875/1 and EP/T017899/1. |
| Faculty \ School: | Faculty of Science > School of Mathematics (former - to 2024) |
| UEA Research Groups: | Faculty of Science > Research Groups > Fluid and Solid Mechanics |
| Depositing User: | LivePure Connector |
| Date Deposited: | 14 Oct 2024 16:30 |
| Last Modified: | 14 Oct 2024 16:30 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/97015 |
| DOI: | 10.1167/iovs.65.12.9 |
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