1. Clinical Scenarios & Presets
2. Compartment Parameters
CSF Production (Iform)
0.35 mL/min
Outflow Resistance (Rout)
8.5 mmHg·min/mL
Interstitial Convective Fraction (kglymph)
0.42
Surgical Drainage Bypass (Qshunt)
0.12 mL/min
3. Export & Reset
Elevated Overdrainage Risk (18%)
Surgical drainage drops ICP significantly below physiological sagittal sinus pressure threshold (6 mmHg), predisposing to bridging vein tearing and subdural hematoma.
CSF Fluid Streamlines
Amyloid-β / Tau Solute Flux
Surgical Shunt Ventricular Port
Interactive Compartmental Solver (Marmarou 3-P Equation)
Calculated ICP
7.8 mmHg
-3.7 vs baseline 11.5
Aβ Daily Turnover
+14.3 %
Bulk shunt + glymphatic
Sagittal Sinus Gradient
1.8 mmHg
Pss baseline: 6.0 mmHg
Clinical RCT Verdict
Unproven
Phase III SILVER-AD: No cognitive gain
4. Nature Investigation: Mechanism vs. Clinical Trials
| Intervention / Mechanism | Biophysical Target | Clinical Trial Evidence (RCTs) | Adverse Complication Risk |
|---|---|---|---|
| Ventricular CSF Shunting (COGNIShunt) | Bulk CSF volume drain (0.10–0.15 mL/min) to lower soluble amyloid load | Phase 3 Negative No delay in ADAS-Cog cognitive decline in 215-patient multicenter RCT. | Subdural hematoma (12–18%), shunt infection (6%), overdrainage headache. |
| Dural Lymphatic / Sinus Stenting | Reduces sagittal outflow resistance to restore natural glymphatic outflow | Early Preclinical Demonstrated in transgenic rodent models; human clinical efficacy pending. | Vascular thrombosis, vessel dissection, in-stent restenosis. |
| Slow-Wave Sleep Consolidation | Natural 60% interstitial volume increase via AQP4 astroglial channels | Strong Physiological Evidence 2-fold increase in radioactive tracer clearance during slow-wave sleep. | Zero surgical morbidity (Non-invasive behavioral/pharmacological). |