The Effect of Cranioplasty on Cerebrospinal Fluid Dynamics in the Cerebral Aqueduct

OBJECTIVE: This study investigated the cerebrospinal fluid (CSF) dynamic changes before and after cranioplasty using phase-contrast cine magnetic resonance imaging. METHODS: We performed a prospective observational study in the patients who underwent cranioplasty in the neurosurgical department of our hospital between June 2022 and March 2025. We reviewed the changes of CSF flow parameters in the cerebral aqueduct before and after cranioplasty. RESULTS: Totally, nine patients were enrolled, including five males and four females, with a mean age of 48.1 years. The time interval between decompressive craniectomy (DC) and cranioplasty was 119.1±45.1 days. The skull defect diameter and area were 10.7±2.2 cm and 94.4±34.6 cm2, respectively. There are significant increases in forward flow volume (p=0.002), backward flow volume (p=0.002), net stroke volume (p=0.012), absolute stroke volume (p=0.001), mean flux (p=0.005), mean velocity (p=0.001), and peak velocity (p