脑积水
心室肥大
脑脊液
脉络丛
医学
颅内压
薄壁组织
病理
淋巴系统
神经科学
心理学
中枢神经系统
生物
内科学
外科
胎儿
怀孕
遗传学
作者
Phan Q. Duy,Neel H. Mehta,Kristopher T. Kahle
出处
期刊:Brain
[Oxford University Press]
日期:2024-05-27
标识
DOI:10.1093/brain/awae155
摘要
Abstract Hydrocephalus, characterized by progressive expansion of the cerebrospinal fluid (CSF)-filled ventricles (ventriculomegaly), is the most common reason for brain surgery. “Communicating” (i.e., non-obstructive) hydrocephalus is classically attributed to a primary derangement in CSF homeostasis, such as choroid plexus-dependent CSF hypersecretion, impaired cilia-mediated CSF flow currents, or decreased CSF reabsorption via the arachnoid granulations or other pathways. Emerging data suggest abnormal biomechanical properties of the brain parenchyma are an underappreciated driver of ventriculomegaly in multiple forms of communicating hydrocephalus across the lifespan. We discuss recent evidence from human and animal studies that suggests impaired neurodevelopment in congenital hydrocephalus, neurodegeneration in elderly normal pressure hydrocephalus, and, in all age groups, inflammation-related neural injury post-infectious and post-hemorrhagic hydrocephalus, can result in loss of stiffness and viscoelasticity of the brain parenchyma. Abnormal brain biomechanics creates barrier alterations at the brain-CSF interface that pathologically facilitates secondary enlargement of the ventricles, even at normal or low intracranial pressures. This “brain-centric” paradigm has implications for the diagnosis, treatment, and study of hydrocephalus from womb to tomb.
科研通智能强力驱动
Strongly Powered by AbleSci AI