scholarly journals Hydrocephalus Revisited: New Insights Into Dynamics of Neurofluids on Macroand Microscales

2020 ◽  
Author(s):  
Hans Ludwig ◽  
Christoph Bock ◽  
Jutta Gärtner ◽  
Stina Schiller ◽  
Jens Frahm ◽  
...  
Keyword(s):  
Driving Force ◽  
Spontaneous Intracranial Hypotension ◽  
Normal Pressure ◽  
Clinical Findings ◽  
Water Regulation ◽  
Csf Flow ◽  
Brain Ventricles ◽  
Molecular Scale ◽  
Mri Evaluation ◽  
Brain Water

New experimental and clinical findings question the historic view of hydrocephalus and its 100-year-old classification. In particular, real-time MRI evaluation of CSF flow and detailed insights into brain water regulation on the molecular scale indicate the existence of at least three main mechanisms that determine the dynamics of neurofluids. (i) Inspiration is a major driving force (ii) Adequate filling of brain ventricles by balanced cerebrospinal fluid upsurge is sensed by cilia (iii) The perivascular glial network connects the ependymal surface to the pericapillary Virchow-Robin spaces. Hitherto, these aspects have not been considered a common physiologic framework improving knowledge and therapy for severe disorders of normal-pressure and post-haemorrhagic hydrocephalus, spontaneous intracranial hypotension and spaceflight disease.

scholarly journals Hydrocephalus Revisited: New Insights into Dynamics of Neurofluids on Macro- and Microscales

2021 ◽  
Author(s):  
Hans C. Ludwig ◽  
Hans C. Bock ◽  
Jutta Gärtner ◽  
Stina Schiller ◽  
Jens Frahm ◽  
...  
Keyword(s):  
Spontaneous Intracranial Hypotension ◽  
Normal Pressure ◽  
Clinical Findings ◽  
Water Regulation ◽  
Resonance Imaging ◽  
Csf Flow ◽  
Posthemorrhagic Hydrocephalus ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Evaluation ◽  
Brain Water

AbstractNew experimental and clinical findings question the historic view of hydrocephalus and its 100-year-old classification. In particular, real-time magnetic resonance imaging (MRI) evaluation of cerebrospinal fluid (CSF) flow and detailed insights into brain water regulation on the molecular scale indicate the existence of at least three main mechanisms that determine the dynamics of neurofluids: (1) inspiration is a major driving force; (2) adequate filling of brain ventricles by balanced CSF upsurge is sensed by cilia; and (3) the perivascular glial network connects the ependymal surface to the pericapillary Virchow–Robin spaces. Hitherto, these aspects have not been considered a common physiologic framework, improving knowledge and therapy for severe disorders of normal-pressure and posthemorrhagic hydrocephalus, spontaneous intracranial hypotension, and spaceflight disease.

From finch to fish to man: Role of aquaporins in body fluid and brain water regulation

Neuroscience ◽  
2004 ◽  
Vol 129 (4) ◽  
pp. 897-904 ◽  
Author(s):  
R.W. Schrier ◽  
Y.-C. Chen ◽  
M.A. Cadnapaphornchai
Keyword(s):  
Body Fluid ◽  
Water Regulation ◽  
Brain Water

Progressive ventricular dilatation following pneumoencephalography

1972 ◽  
Vol 36 (1) ◽  
pp. 50-59 ◽  
Author(s):  
Richard L. Rovit ◽  
Mannie M. Schechter ◽  
Benbienizi Ortega ◽  
Ray A. Brinker
Keyword(s):  
Normal Pressure Hydrocephalus ◽  
Clinical Evidence ◽  
Normal Pressure ◽  
Ventricular Dilatation ◽  
Additional Parameter ◽  
Contrast Study ◽  
Csf Flow ◽  
Content Type ◽  
Radiological Studies ◽  
Basal Cisterns

✓ Eight patients with “normal pressure hydrocephalus” are presented who demonstrated radiographic and occasional clinical evidence of progressive dilatation of the ventricles following pneumoencephalography. The characteristic pneumographic signs of tentorial obstruction to the flow of cerebrospinal fluid (CSF) had been documented in the original air contrast study. The authors postulate that pneumoencephalography in patients with normal pressure hydrocephalus may result in a sudden displacement of CSF from the ventricles into the already compromised basal cisterns, leading to further obstruction of CSF outflow and progressive ventricular dilatation. Other mechanisms such as reduction in the potential resorptive capacity of the ventricular ependyma by air replacing ventricular fluid may play a part. The value of repeat radiological studies 24 and 48 hours after the original pneumogram is emphasized both as an aid in the radiological diagnosis of normal pressure hydrocephalus and as an additional parameter for studying problems in CSF flow and absorption.

Diffusion Tensor Imaging in Patients With Adult Chronic Idiopathic Hydrocephalus

Neurosurgery ◽  
2010 ◽  
Vol 66 (5) ◽  
pp. 917-924 ◽  
Author(s):  
Elke Hattingen ◽  
Alina Jurcoane ◽  
Julia Melber ◽  
Stella Blasel ◽  
Friedhelm E. Zanella ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Normal Pressure ◽  
Clinical Findings ◽  
Control Group ◽  
Microstructural Changes ◽  
Automated Method ◽  
Definition Of ◽  
Lumbar Cerebrospinal Fluid

Abstract OBJECTIVE Diffusion tensor imaging (DTI) parameters were investigated in patients with chronic idiopathic hydrocephalus to evaluate microstructural changes of brain tissue caused by chronic ventricular dilatation. METHODS Eleven patients fulfilling the criteria for possible or probable idiopathic normal pressure hydrocephalus and 10 healthy control subjects underwent MRI at 3 Tesla, including DTI with 12 gradient directions. Patients were scanned before lumbar cerebrospinal fluid (CSF) withdrawal tests. Differences in fractional anisotropy (FA) and mean diffusivity (MD) between patients and controls were assessed using 2 different methods: manual definition of regions of interest and a fully automated method, TBSS (Tract-Based Spatial Statistics). DTI parameters were correlated with clinical findings. RESULTS Compared with the control group, patients with chronic idiopathic hydrocephalus had significantly higher MD values in both the periventricular corticospinal tract (CST) and the corpus callosum (CC), whereas FA values were significantly higher in the CST but lower in the CC. DTI parameters of the CST correlated with the severity of gait disturbances. CONCLUSION Microstructural changes in periventricular functionally relevant white matter structures (CSF, CC) in chronic idiopathic hydrocephalus can be visualized using DTI. Further studies should investigate the change of DTI parameters after CSF shunting and its relation to neurologic outcome.

Spontaneous intracranial hypotension: morphological findings and CSF flow dynamics studied by MRI

2004 ◽  
Vol 14 (6) ◽  
pp. 1013-1016 ◽  
Author(s):  
Zafiria Metafratzi ◽  
Maria I. Argyropoulou ◽  
Christina Mokou-Kanta ◽  
Spiros Konitsiotis ◽  
Anastasia Zikou ◽  
...  
Keyword(s):  
Intracranial Hypotension ◽  
Spontaneous Intracranial Hypotension ◽  
Flow Dynamics ◽  
Csf Flow ◽  
Morphological Findings

Cine-MR Imaging of Aqueductal CSF Flow in Normal Pressure Hydrocephalus Syndrome before and after CSF Shunt

1993 ◽  
Vol 34 (6) ◽  
pp. 586-592 ◽  
Author(s):  
M. Mascalchi ◽  
G. Arnetoli ◽  
D. Inzitari ◽  
G. Dal Pozzo ◽  
F. Lolli ◽  
...  
Keyword(s):  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Csf Shunt ◽  
Communicating Hydrocephalus ◽  
Csf Flow ◽  
Cine Mr ◽  
Csf Shunting ◽  
Before And After ◽  
Flow Void ◽  
Central Flow

Reproducibility of the aqueductal CSF signal intensity on a gradient echo cine-MR sequence exploiting through plane inflow enhancement was tested in 11 patients with normal or dilated ventricles. Seven patients with normal pressure hydrocephalus (NPH) syndrome were investigated with the sequence before and after CSF shunting. Two patients exhibiting central flow void within a hyperintense aqueductal CSF improved after surgery and the flow void disappeared after shunting. One patient with increased maximum and minimum aqueductal CSF signal as compared to 18 healthy controls also improved and the aqueductal CSF signal was considerably decreased after shunting. Three patients with aqueductal CSF values similar to those in the controls did not improve, notwithstanding their maximum aqueductal CSF signals decreasing slightly after shunting. No appreciable aqueductal CSF flow related enhancement consistent with non-communicating hydrocephalus was found in the last NPH patient who improved after surgery. Cine-MR with inflow technique yields a reproducible evaluation of flow-related aqueductal CSF signal changes which might help in identifying shunt responsive NPH patients. These are likely to be those with hyperdynamic aqueductal CSF or aqueductal obstruction.

scholarly journals Clinical Diagnosis and Treatment Management of Normal Pressure Hydrocephalus

2021 ◽  
Author(s):  
Hüseyin Yakar
Keyword(s):  
Quality Of Life ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Clinical Findings ◽  
Treatment Modalities ◽  
Arachnoid Granulation ◽  
Elderly Individuals ◽  
Clinical Triad ◽  
Unusual Appearance

Inadequate absorption of cerebrospinal fluid (CSF) at the arachnoid granulation level during circulation results in an increase in CSF in the ventricle and certain neuropsychiatric clinical findings. This syndrome, which often presents with ventricular dilatation, progressive cognitive decline, walking difficulties, and urinary incontinence symptoms in elderly individuals, is called Normal Pressure Hydrocephalus (NPH). It is projected that as people’s quality of life improves and their life expectancy rises, more old people would develop this condition. Although a clear clinical triad has been defined, the identification of patients with NPH and the application of effective treatment modalities still pose a number of challenges for neurosurgeons today. However, despite all these difficulties, if diagnosed and treated early, the unusual appearance of these symptoms affecting elderly individuals can be prevented and significant improvements in quality of life can be achieved.

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