Corticosteroid therapy of experimental hydrocephalus after intraventricular-subarachnoid haemorrhage

Wilkinson, Harold A.; Wilson, Rene B.; Patel, Priyadarshee; Esmaili, M.H.

doi:10.1136/jnnp.37.2.224

Cited by 20 publications

(7 citation statements)

References 16 publications

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“…An experimental study in rabbits found that the incidence of hydrocephalus after subarachnoid hemorrhage could be reduced by intramuscular steroid therapy aimed at blunting the inflammatory response in the arachnoid villi. 29 Intracranial compliance depends mainly on CSF flow oscillations and vascular compliance.…”

Section: Csf Flow Alterationmentioning

confidence: 99%

Relationship Between Cerebrospinal Fluid and Blood Dynamics in Healthy Volunteers and Patients with Communicating Hydrocephalus

Balédent

Gondry-Jouet²,

Meyer³

et al. 2004

Investigative Radiology

166

156

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Section: Csf Flow Alterationmentioning

confidence: 99%

Relationship Between Cerebrospinal Fluid and Blood Dynamics in Healthy Volunteers and Patients with Communicating Hydrocephalus

Balédent

Gondry-Jouet²,

Meyer³

et al. 2004

Investigative Radiology

166

156

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“…Because inflammation in the CSF pathways accompanies hemorrhage (83), anti-inflammatory therapy (eg, corticosteroids) has been attempted. Again, success has been minimal in preventing hydrocephalus after hemorrhage (39,125).…”

Section: Pharmacologic Interventionmentioning

confidence: 99%

Cellular Damage and Prevention in Childhood Hydrocephalus

Bigio

2004

Brain Pathology

115

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The literature concerning brain damage due to hydrocephalus, especially in children and animal models, is reviewed. The following conclusions are reached: 1. Hydrocephalus has a deleterious effect on brain that is dependent on magnitude and duration of ventriculomegaly and modified by the age of onset. 2. Animal models have many histopathological similarities to humans and can be used to understand the pathogenesis of brain damage. 3. Periventricular axons and myelin are the primary targets of injury. The pathogenesis has similarities to traumatic and ischemic white matter injury. Secondary changes in neurons reflect compensation to the stress or ultimately the disconnection. 4. Altered efflux of extracellular fluid could result in accumulation of waste products that might interfere with neuron function. Further research is needed in this as well as the blood-brain barrier in hydrocephalus. 5. Some, but not all, of the changes are preventable by shunting CSF. However, axon loss cannot be reversed, therefore shunting in a given case must be considered carefully. 6. Experimental work has so far failed to show any benefit in reducing CSF production. Pharmacologic protection of the brain, at least as a temporary measure, holds some promise but more pre-clinical research is required.

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“…In addition to a suggested reduction of cerebral edema by unknown mechanisms (19), this effect of methylprednisolone may explain the reduction in ICP seen after their administration. Steroids also lyse adhesions in the SAS (65) and may prevent the occurrence of postmeningitic hydrocephalus; this phenomenon has been demonstrated for late hydrocephalus occurring after experimental subarachnoid hemorrhage in rabbits (66). In addition to decreasing resistance to CSF outflow, corticosteroids may also decrease CSF production (67), although this finding has been disputed by other investigators.…”

Section: Effect Of Methylprednisolonementioning

confidence: 57%

Cerebrospinal fluid outflow resistance in rabbits with experimental meningitis. Alterations with penicillin and methylprednisolone.

Scheld¹,

Dacey²,

Winn³

et al. 1980

J. Clin. Invest.

195

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Corticosteroid therapy of experimental hydrocephalus after intraventricular-subarachnoid haemorrhage

Cited by 20 publications

References 16 publications

Relationship Between Cerebrospinal Fluid and Blood Dynamics in Healthy Volunteers and Patients with Communicating Hydrocephalus

Relationship Between Cerebrospinal Fluid and Blood Dynamics in Healthy Volunteers and Patients with Communicating Hydrocephalus

Cellular Damage and Prevention in Childhood Hydrocephalus

Cerebrospinal fluid outflow resistance in rabbits with experimental meningitis. Alterations with penicillin and methylprednisolone.

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