Towards Patient Anatomy-Based Simulation of Net Cerebrospinal Fluid Flow in the Intracranial Compartment

Biophysics-based, patient-specific modeling remains challenging for clinical translation, particularly for cerebrospinal fluid (CSF) flow where anatomical detail and computational cost are tightly coupled. We present a computational framework for steady net CSF redistribution in an MRI-derived cranial CSF domain reconstructed from T2-weighted imaging, including the ventricular system, cranial subarachnoid space, and periarterial pathways, to the extent resolvable by clinical MRI. Cranial CSF spaces were segmented in 3D Slicer and a steady Darcy formulation with prescribed CSF production/absorption was solved in COMSOL Multiphysics®. Geometrical and flow descriptors were quantified using region-based projection operations. We assessed discretization cost–accuracy trade-offs by comparing first- and second-order finite elements. First-order elements produced a 1.4% difference in transmantle pressure and a