An autopsy case of congenital hydrocephalus and severe thinning of the cerebral cortex in a 4‐year‐old boy

Alterations in Cortical Thickness and White Matter Integrity in Mild-to-Moderate Communicating Hydrocephalic School-Aged Children Measured by Whole-Brain Cortical Thickness Mapping and DTI

“…Widespread cortical thinning was previously reported in animal models and children with severe hydrocephalus [ 13 , 15 , 28 , 29 ]. This is consistent with the pathology studies, which revealed moderate-to-severe neuronal swelling of the whole brain in hydrocephalus patients, with marked enlargement of the extracellular space in the adjacent neuropil, synaptic plasticity and degeneration, damage to myelinated axons, and myelination delay.…”

“…This is consistent with the pathology studies, which revealed moderate-to-severe neuronal swelling of the whole brain in hydrocephalus patients, with marked enlargement of the extracellular space in the adjacent neuropil, synaptic plasticity and degeneration, damage to myelinated axons, and myelination delay. Astrocytes also display evidence of edema and phagocytic activity [ 29 , 30 ]. These pathological changes in the cerebral cortex of human hydrocephalus patients are considered to result from an initial mechanical injury because of the high CSF pressure, followed by secondary changes associated with increased interstitial edema, ischemia, and oxidative stress [ 31 ].…”

“…Current studies provided further evidences in vivo that the white matter deficits were prominent in the right corpus callosum body. Compared to the previous studies in patients with severe hydrocephalus, our research focused on mild-to-moderate communicating hydrocephalic children who had shorter duration and lower-level hydrocephalus than those of previous studies [ 13 , 15 , 28 , 29 , 32 – 37 ]. These findings suggest that the corpus callosum is the most vulnerable white matter tract under hydrocephalus, which happens early in the course of the illness.…”