An update on research priorities in hydrocephalus: overview of the third National Institutes of Health-sponsored symposium “Opportunities for Hydrocephalus Research: Pathways to Better Outcomes”

McAllister, James P.; Williams, Michael A.; Walker, Marion L.; Kestle, John R. W.; Relkin, Norman; Anderson, Alan Ross; Gross, Paul; Browd, Samuel R.

doi:10.3171/2014.12.jns132352

Cited by 88 publications

(59 citation statements)

References 134 publications

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“…A 2015 National Institutes of Health-sponsored symposium listed the elucidation of the mechanisms underlying CSF production and the discovery of related drug therapies as top priorities for hydrocephalus research. 87 Critical in the effort to develop novel drugs to inhibit CSF secretion is defining the critical regulatory pathways that mediate this process. In any complex physiological process with multiple overlapping regulatory pathways, molecular genetics (both mouse and human) has the power to pinpoint key homeostatic nodes in an unbiased way.…”

Section: Novel Strategies For Targeting Csf Production For the Treatmmentioning

confidence: 99%

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Cerebrospinal fluid hypersecretion in pediatric hydrocephalus

Karimy¹,

Durán²,

Hu³

et al. 2016

FOC

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Hydrocephalus, despite its heterogeneous causes, is ultimately a disease of disordered CSF homeostasis that results in pathological expansion of the cerebral ventricles. Our current understanding of the pathophysiology of hydrocephalus is inadequate but evolving. Over this past century, the majority of hydrocephalus cases has been explained by functional or anatomical obstructions to bulk CSF flow. More recently, hydrodynamic models of hydrocephalus have emphasized the role of abnormal intracranial pulsations in disease pathogenesis. Here, the authors review the molecular mechanisms of CSF secretion by the choroid plexus epithelium, the most efficient and actively secreting epithelium in the human body, and provide experimental and clinical evidence for the role of increased CSF production in hydrocephalus. Although the choroid plexus epithelium might have only an indirect influence on the pathogenesis of many types of pediatric hydrocephalus, the ability to modify CSF secretion with drugs newer than acetazolamide or furosemide would be an invaluable component of future therapies to alleviate permanent shunt dependence. Investigation into the human genetics of developmental hydrocephalus and choroid plexus hyperplasia, and the molecular physiology of the ion channels and transporters responsible for CSF secretion, might yield novel targets that could be exploited for pharmacotherapeutic intervention.

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Section: Novel Strategies For Targeting Csf Production For the Treatmmentioning

confidence: 99%

“…pathogenesis of congenital hydrocephalus, 78 and although results of animal studies have contributed to our understanding of the disease, 87 our knowledge of the genetic determinants and molecular mechanisms of most types of pediatric hydrocephalus, especially developmental (i.e., congenital) hydrocephalus, is primitive.…”

mentioning

confidence: 99%

Cerebrospinal fluid hypersecretion in pediatric hydrocephalus

Karimy¹,

Durán²,

Hu³

et al. 2016

FOC

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“…13,39 The prevalence of this disease is age related, reaching 1%-5.9% among elderly individuals. 21,26 It remains one of the most controversial neuropathological entities both in regards to its diagnosis and its proper management.…”

mentioning

confidence: 99%

The role of diffusion tensor imaging and fractional anisotropy in the evaluation of patients with idiopathic normal pressure hydrocephalus: a literature review

Siasios

Kapsalaki²,

Fountas³

et al. 2016

FOC

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OBJECTIVE Diffusion tensor imaging (DTI) for the assessment of fractional anisotropy (FA) and involving measurements of mean diffusivity (MD) and apparent diffusion coefficient (ADC) represents a novel, MRI-based, noninvasive technique that may delineate microstructural changes in cerebral white matter (WM). For example, DTI may be used for the diagnosis and differentiation of idiopathic normal pressure hydrocephalus (iNPH) from other neurodegenerative diseases with similar imaging findings and clinical symptoms and signs. The goal of the current study was to identify and analyze recently published series on the use of DTI as a diagnostic tool. Moreover, the authors also explored the utility of DTI in identifying patients with iNPH who could be managed by surgical intervention. METHODS The authors performed a literature search of the PubMed database by using any possible combinations of the following terms: “Alzheimer's disease,” “brain,” “cerebrospinal fluid,” “CSF,” “diffusion tensor imaging,” “DTI,” “hydrocephalus,” “idiopathic,” “magnetic resonance imaging,” “normal pressure,” “Parkinson's disease,” and “shunting.” Moreover, all reference lists from the retrieved articles were reviewed to identify any additional pertinent articles. RESULTS The literature search retrieved 19 studies in which DTI was used for the identification and differentiation of iNPH from other neurodegenerative diseases. The DTI protocols involved different approaches, such as region of interest (ROI) methods, tract-based spatial statistics, voxel-based analysis, and delta-ADC analysis. The most studied anatomical regions were the periventricular WM areas, such as the internal capsule (IC), the corticospinal tract (CST), and the corpus callosum (CC). Patients with iNPH had significantly higher MD in the periventricular WM areas of the CST and the CC than had healthy controls. In addition, FA and ADCs were significantly higher in the CST of iNPH patients than in any other patients with other neurodegenerative diseases. Gait abnormalities of iNPH patients were statistically significantly and negatively correlated with FA in the CST and the minor forceps. Fractional anisotropy had a sensitivity of 94% and a specificity of 80% for diagnosing iNPH. Furthermore, FA and MD values in the CST, the IC, the anterior thalamic region, the fornix, and the hippocampus regions could help differentiate iNPH from Alzheimer or Parkinson disease. Interestingly, CSF drainage or ventriculoperitoneal shunting significantly modified FA and ADCs in iNPH patients whose condition clinically responded to these maneuvers. CONCLUSIONS Measurements of FA and MD significantly contribute to the detection of axonal loss and gliosis in the periventricular WM areas in patients with iNPH. Diffusion tensor imaging may also represent a valuable noninvasive method for differentiating iNPH from other neurodegenerative diseases. Moreover, DTI can detect dynamic changes in the WM tracts after lumbar drainage or shunting procedures and could help identify iNPH patients who may benefit from surgical intervention.

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“…4 Hidrosefalus dapat menyebabkan konsekuensi yang serius pada anak meliputi penurunan kapasitas intelektual, defisit motorik, kesulitan perilaku sehingga memengaruhi kualitas hidup anak yang terbawa hingga dewasa. 5 Penyebab hidrosefalus dapat terjadi pada masa prenatal dan perinatal, tetapi hal-hal apa saja yang memicu terjadinya kelainan tersebut sebagian besar belum diketahui secara pasti. 7 Pemicu hidrosefalus tersering adalah perdarahan diikuti neoplasma dan infeksi meningitis.…”

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Profil Klinis dan Faktor Risiko Hidrosefalus Komunikans dan Non Komunikans pada Anak di RSUD dr. Soetomo

Rahmayani

Gunawan

Utomo

2017

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Latar belakang. Hidrosefalus merupakan salah satu kelainan kongenital tersering pada anak yang dapat menyebabkan penurunan kualitas hidup anak. Penyebab hidrosefalus masih belum banyak diketahui dan faktor risikonya belum banyak dipelajari. Tujuan. Mengevaluasi dan mengidentifikasi faktor risiko yang berhubungan dengan terjadinya hidrosefalus komunikans dan non komunikans pada anak. Metode. Penelitian analitik observasional pada 80 pasien anak yang menderita hidrosefalus dengan menggunakan data sekunder di pusat rekam medis RSUD dr. Soetomo. Analisis menggunakan chi-square dan regresi logistik. Hasil. Prevalensi hidrosefalus komunikans dan non komunikans adalah 41,25% dan 58,75%. Hasil analisis menunjukkan meningoensefalitis memiliki hubungan dengan hidrosefalus komunikans (p=0,023). Data statistik menunjukkan bahwa manifestasi klinis terbanyak pada hidrosefalus adalah edema otak. Background. Hydrocephalus is one of the most common congenital disease in children leading to decrease quality of life. The cause of hydrocephalus is still poorly understood and its risk factors have not been much studied.Objective. To evaluate and identify the risk factors associated with pediatric communicating and non communicating hydrocephalus.Method. An analitic observational study, that was conducted in 80 pediatric patient who suffer hydrocephalus using secondary data at center of medical records in RSUD dr. Soetomo. Analysis using Chi-squre and binary logistic regression. Result. Prevalence of communicating hydrocephalus is 41,25% and prevalence of non-communicating hydrocephalus is 58,75%. The result showed that meningoencephalitis has correlation to communicating hydrocephalus(sig=0.023). Statistic data showed the most clinical manifestation of hydrocephalus is brain edema. Conclusion.Meningoencephalitis is a risk factor of communicating hydrocephalus.

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An update on research priorities in hydrocephalus: overview of the third National Institutes of Health-sponsored symposium “Opportunities for Hydrocephalus Research: Pathways to Better Outcomes”

Cited by 88 publications

References 134 publications

Cerebrospinal fluid hypersecretion in pediatric hydrocephalus

Cerebrospinal fluid hypersecretion in pediatric hydrocephalus

The role of diffusion tensor imaging and fractional anisotropy in the evaluation of patients with idiopathic normal pressure hydrocephalus: a literature review

Profil Klinis dan Faktor Risiko Hidrosefalus Komunikans dan Non Komunikans pada Anak di RSUD dr. Soetomo

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