Abstract
Cerebrospinal fluid (CSF) is a clear, water-like fluid that surrounds the brain and spinal cord and is located in interconnected reservoir-like spaces within, and around, the brain called ventricles and cisterns (Figure 1). Total CSF system fluid volume in an adult is ~150 ml with an average pressure of ~10-15 mmHg when lying in the supine position [1]. CSF moves in an oscillatory manner in synchrony with the cardiac cycle due to cerebral blood flow pulsations and is also impacted by the respiratory cycle [2]. CSF plays a mechanistic role to cushion the delicate central nervous system tissue by the Archimedes principle and also plays a functional role to remove waste products and deliver nutrients to the CNS tissues. Recent research has shown that tracers introduced to the CSF rapidly move into the brain tissue via the perivascular spaces [3]. Many medical applications are rapidly developing that incorporate virtual and/or augmented reality (VR / AR). At present,
VR is used widely as a rehabilitation tool as it can safely create an augmented reality using realistic scenarios [4]. The presence of VR in the medical field is an accessible cost cutting tool; however, less than 20% of medical VR software uses immersive, VR technology [1]. Visualization of the complex CSF system is helpful to understand
its geometry and functional importance. The CSF system contains micro-anatomical features, such as nerve rootlets, the cerebellar and cerebral fissures, as well as the ventricular volumes and passages that are difficult to visualize without physical or VR representation. A VR simulator of the CSF system could be helpful as a teaching tool and as
robotic simulator for neurosurgical procedures. Our aim was to create a CSF system VR simulator that allows a) endoscopic-like navigation within the CSF system and b) colocation of the endoscope location and medical imaging used to create the model.