What we don’t (but should) know about hydrocephalus

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  • 1 Department of Neurosurgery, University of California at Los Angeles, California; Department of Neurosurgery, New York Spine and Brain Surgery, State University of New York, Stony Brook, New York; Neuroscience Research Program, Sunnybrook & Women’s Health Sciences Centre, Toronto, Ontario, Canada; Hydrocephalus Association, San Francisco, California; Department of Neurosurgery, Boston Children’s Hospital, Boston, Massachusetts; Department of Neurosurgery, Children’s Hospital of Michigan, Detroit, Michigan; Brain Child Foundation, Carefree, Arizona; Division of Pediatric Neurosurgery, Primary Children’s Hospital, Salt Lake City, Utah; and Department of Neurology, The Johns Hopkins Hospital, Baltimore, Maryland
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✓In an effort to identify critical gaps in the prevailing knowledge of hydrocephalus, the authors formulated 10 key questions. 1) How do we define hydrocephalus? 2) How is cerebrosinal fluid (CSF) absorbed normally and what are the causes of CSF malabsorption in hydrocephalus? 3) Why do the ventricles dilate in communicating hydrocephalus? 4) What happens to the structure and function of the brain when it is compressed and stretched by the expanding ventricles? 5) What is the role of cerebrovenous pressure in hydrocephalus? 6) What causes normal-pressure hydrocephalus? 7) What causes low-pressure hydrocephalus? 8) What is the pathophysiology of slit ventricle syndrome? 9) What is the pathophysiological basis for neurological impairment in hydrocephalus, and to what extent is it reversible? 10) How is the brain of a child with hydrocephalus different from that of a young or elderly adult? Rigorous answers to these questions should lead to more effective and reliable treatments for this disorder.

Abbreviations used in this paper:

CSF = cerebrospinal fluid; ICP = intracranial pressure; NPH = normal-pressure hydrocephalus; SVS = slit ventricle syndrome.

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Contributor Notes

Address reprint requests to: James P. McAllister II, Ph.D., Department of Neurological Surgery, Wayne State University School of Medicine, 4201 Street Antoine, Suite UHC-6E, Detroit, Michigan 48201. email: pmcallister@med.wayne.edu.
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