Hydrocephalus Revisited: New Insights into Dynamics of Neurofluids on Macro- and Microscales.
Hans-Christoph LudwigHans Christoph BockJutta GärtnerStina SchillerJens FrahmSteffi Dreha-KulaczewskiPublished in: Neuropediatrics (2021)
New 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.
Keyphrases
- cerebrospinal fluid
- magnetic resonance imaging
- resting state
- white matter
- contrast enhanced
- functional connectivity
- single molecule
- machine learning
- healthcare
- deep learning
- computed tomography
- cerebral ischemia
- diffusion weighted imaging
- magnetic resonance
- multiple sclerosis
- neuropathic pain
- blood brain barrier
- optical coherence tomography