Restricted arterial expansion as a universal causative factor in communicating hydrocephalus
The cerebrospinal fluid (CSF) flow in the aqueduct and below the foramen magnum and the blood flow in the superior sagittal sinus (SSS) were examined in ten patients with communicating hydrocephalus and six controls, using cardiac-gated MR-phase images. The cervical CSF pulsations were found to be significantly decreased in communicating hydrocephalus reflecting a decreased expansion of the intracranial arteries, in accordance with a previous study. The stroke volume and the rise and delay times for the systolic peak in the SSS were also decreased, as was the pulsatility index for diastole. The reduced expansion of the arteries is regarded as the main causative factor in communicating hydrocephalus. According to the theory, any process that restricts this expansion, such as arterial disease and obstruction of the paravascular spaces, may cause communicating hydrocephalus. It is suggested that the same mechanism explains hydrocephalus accompanying obstruction of the subarachnoid space near the craniocervical junction as seen with cervical spinal stenosis and Chiari malformations.
Key wordsHydrocephalus Arterial expansion Cerebrospinal fluid, flow dynamics Superior sagittal sinus, flow dynamics Magnetic resonance imaging
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- 5.Ekstedt J, Friden H (1984) CSF hydrodynamics of the study of adult hydrocephalus syndrome. In: Shapiro K, Marmarou A, Portnoy H (eds) Hydrocephalus. Raven Press, New York, pp 363–382.Google Scholar