“…From a different perspective, a number of investigators working on experimental hydrocephalus and attempting to elucidate the influence of brain coverings on its development, added to their studied animals craniectomies and durotomies. While these procedures by themselves caused no significant change in the ventricular size nor in the sagittal sinus pressure 4,6,7 , when those animals were submitted to a ventricular perfusion, to the determination of pressure volume index (PVI) or induced into experimental hydrocephalus, a significant reduction in the elastic properties of the brain parenchyma became evident, together with a significant increase in the ventricular distensibility, and a dramatic increase in the capacity of their ventricular system to accommodate added volume 4,6,19,20 . From all of the above, it becomes clear that a decompressive craniectomy with a duroplasty provides definite conditions that would promote the generation of hydrocephalus, without even considering potential additional factors, such as brain trauma, ischemia or other pathologies that could cause an increase in cerebral tissue or CSF osmolality and further exacerbate the proclivity for hydrocephalus.…”