“Compensated hyperosmolarity” of cerebrospinal fluid and the development of hydrocephalus

Klarica, Marijan; Miše, Branko; Vladić, Anton; Radoš, Marko; Orešković, Darko

doi:10.1016/j.neuroscience.2013.06.022

Cited by 50 publications

(66 citation statements)

References 41 publications

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“…Our hypothesis is supported with experiments in which distribution of water (radioactively labeled), after its application into the blood or into different CSF compartments, is followed in mice [34] , dogs [35] , cats [41] , and patients [33,48] . These results imply that the water arrives very quickly and evenly into all CSF and CNS compartments, i.e.…”

Section: Recent View On Csf Physiologysupporting

confidence: 58%

“…Similar results were observed in cats where hyperosmolar solution was subchronically infused by a minipump into the lateral brain ventricle. Cats infused with hyperosmolar solution had significantly larger ventricles then cats infused with isoosmolar solution [35] . Krishnamurthy et al [44,45,56] have shown in rats that the increase in CSF osmolarity by a chronic intraventricular infusion of hyperosmolar substances leads to the development of hydrocephalus.…”

Section: Recent View On Hydrocephalus Developmentmentioning

confidence: 87%

“…Thus, there is neither a dominant site of water entry into the CSF in any of the animal species (wild-type, knockout mice for aquaporins AQP1 and AQP4 [34,35,41] ), nor in patients before or after plexectomy procedures [33] , nor in healthy volunteers or in those with idiopathic normal pressure hydrocephalus [48] . Faster (more dominant) arrival of water into the CSF was observed only in the case of a local osmolarity increase in one of the CSF compartments, which results in an increase in the CSF volume and pressure, leading to the dilation of ventricles [35,44,45] . Accordingly, the CSF volume is regulated by the correlation between hydrostatic and osmotic forces inside the blood and in the ISF/CSF compartment.…”

Section: Recent View On Csf Physiologymentioning

confidence: 99%

“…Especially because it is well known that in many cases aqueductal stenosis is not the cause of hydrocephalus, but rather a consequence of hydrocephalus development, and that hydrocephalus could develop without the obstruction [10,28,35,44,[50][51][52][53][54][55][56][57] . Furthermore, it was also presented that complete blockade of CSF pathways did not result in dilatation of ventricles or the development of hydrocephalus [10,31,[58][59][60] .…”

Section: Recent View On Hydrocephalus Developmentmentioning

confidence: 99%

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New Concepts of Cerebrospinal Fluid Physiology and Development of Hydrocephalus

2016

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The goal of this review is the presentation of the new (Bulat-Klarica-Orešković) hypothesis of cerebrospinal fluid (CSF) physiology and the ensuing new concept of hydrocephalus development in light of this hypothesis. The widely accepted classic hypothesis of CSF physiology and the traditional concept of hydrocephalus are contradicted by numerous experimental and clinical data, which consequently results in unsatisfying clinical treatment and patient recovery. Therefore, the newly presented concept of hydrocephalus development and possible future treatments are discussed. A new definition suggests that hydrocephalus is a pathological state in which CSF is excessively accumulated inside the cranial part of the CSF system, predominantly in one or more brain ventricles as a consequence of impaired hydrodynamics of intracranial fluids between CSF, brain, and blood compartments.

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Section: Recent View On Csf Physiologysupporting

confidence: 58%

Section: Recent View On Hydrocephalus Developmentmentioning

confidence: 87%

Section: Recent View On Csf Physiologymentioning

confidence: 99%

Section: Recent View On Hydrocephalus Developmentmentioning

confidence: 99%

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New Concepts of Cerebrospinal Fluid Physiology and Development of Hydrocephalus

2016

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“…Two groups have shown that artificial change of osmolarity in ventricular CSF by hyperosmolar infusion into the ventricular system is followed by ventricular enlargement. 67,70,71 If these experiments prove to be valid, it would suggest that ventricular expansion can occur merely by changing the osmolarity, without the specific need for pressure changes or physiological infusion of water.…”

Section: 115mentioning

confidence: 99%

Hydrocephalus: the role of cerebral aquaporin-4 channels and computational modeling considerations of cerebrospinal fluid

Desai¹,

Hsu

Schneller

et al. 2016

FOC

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Aquaporin-4 (AQP4) channels play an important role in brain water homeostasis. Water transport across plasma membranes has a critical role in brain water exchange of the normal and the diseased brain. AQP4 channels are implicated in the pathophysiology of hydrocephalus, a disease of water imbalance that leads to CSF accumulation in the ventricular system. Many molecular aspects of fluid exchange during hydrocephalus have yet to be firmly elucidated, but review of the literature suggests that modulation of AQP4 channel activity is a potentially attractive future pharmaceutical therapy. Drug therapy targeting AQP channels may enable control over water exchange to remove excess CSF through a molecular intervention instead of by mechanical shunting. This article is a review of a vast body of literature on the current understanding of AQP4 channels in relation to hydrocephalus, details regarding molecular aspects of AQP4 channels, possible drug development strategies, and limitations. Advances in medical imaging and computational modeling of CSF dynamics in the setting of hydrocephalus are summarized. Algorithmic developments in computational modeling continue to deepen the understanding of the hydrocephalus disease process and display promising potential benefit as a tool for physicians to evaluate patients with hydrocephalus.

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