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Radiology of Hydrocephalus

From Morphology to Hydrodynamics and Pathogenesis
  • Charles Raybaud
Living reference work entry

Abstract

Cerebrospinal fluid (CSF) is the portion of the extracellular fluid of the brain that is collected in the ventricles and extra-neural spaces. Its role is dual: mechanically it provides the brain with cushioning and buoyancy and distributes evenly the force of the systolic pressure wave; biologically it allows the transport of many secreted molecules to the periventricular zones and circumventricular organs. CSF is secreted by the choroid plexuses and absorbed passively at dural absorption sites, but simultaneously, water can be actively transported by Aquaporin-4 (AQP4) channels in and out the parenchyma across the ependymal and subpial surfaces as well as into the capillaries. Based on this, hydrocephalus can be considered the single mechanical consequence of multiple processes which may affect secretion, absorption, transport, and movements of the CSF, either because of a loss of compliance, because of a secretion-absorption mismatch, or both. Mechanically it affects the brain by compressing the vascular bed, which results in parenchymal ischemic changes. The CSF-parenchyma exchanges may also be affected by the CSF flow alteration, the impact of hydrocephalus on the ependyma and subependymal progenitor zone, and the brain lesions due to the causal pathology. In this perspective, the roles of imaging are to identify hydrocephalus, to understand its mechanism (compliance and secretion-absorption mismatch), to evaluate its effects on the parenchyma, and to analyze the etiology-related pathology in various clinical contexts. Postoperatively, imaging aims at assessing the mechanical efficacy of the CSF diversion and the lack of short-term and long-term complications.

Keywords

CSF pathways, development CSF dynamics Hydrocephalus, pathogenetic processes Hydrocephalus, radiologic assessment Hydrocephalus, follow-up Imaging 

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Neuroradiology, Hospital for Sick ChildrenUniversity of TorontoTorontoCanada

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