By James M. Drake, D. Gordon Potts, Claude Lemaire (auth.), Satoshi Matsumoto M.D., Kiyoshi Sato M.D., Norihiko Tamaki M.D., Shizuo Oi M.D. (eds.)

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Extra resources for Annual Review of Hydrocephalus: Volume 8 1990

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In some patients the integrity of the blood brain barrier may be disrupted as indicated by the presence of serum proteins in the CSF. Changes in the concentrations of neurotransmitters and neuromodulators suggest that the functional status of some neurons is altered in the hydrocephalic brain. The presence of neural cell-derived proteins and enzymes in CSF indicate that periventricular tissue damage may occur. All of these changes are more pronounced when intracranial pressure is elevated. Although no assays of CSF composition have provided an entirely useful guide to aid decisions regarding shunting, they have provided in vivo information regarding the pathophysiology of hydrocephalus.

Each rCBF value was expressed as the percentage of the rCBF values of norm al children in corresponding age groups, as measured in our institution. The fast-flow average was similar to that of normal children, but the slow-flow average was slightly lower. 718, P<0/02), but there was no correlation between fast flow and pre-operative ventricular size. There was no correlation between rCBF and post-operative ventricular size. OI, Fig, A) , but not with fast flow (Hg. B). It is suggested that in children with hydrocephalus impairment of the white-matter communicating fibers results in a secondary higher intellectual activity.

Scan and Conray ventriculogram showed dilated right lateral ventricles . A right ventriculoperitoneal shunt was inserted . Following surgery, headache and cerebellar signs subsided . Oi and Matsumoto introduced the term, progressive unilateral hydrocephalus to describe unilateral ventricular dilatation with CSF circulatory disturbances. They classified this entity into 4 groups depending upon the pathology of obstruction of the foramen of Momo-l) Atresia, 2) Morphological obstruction, 3) Functional obstruction, and 4) Patent foramen with hemispheric parenchymal changes .

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