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Published on: October 1, 2019

Chronic hydrocephalus-induced changes in cerebral blood flow: mediation through cardiac effects

Stephen M Dombrowski1, Soren Schenk, Anna Leichliter

  • 1Department of Neurological Surgery, Pediatric and Congenital Neurological Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. dombros@ccf.org

Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism
|February 24, 2006
PubMed

Insights

Chronic hydrocephalus (CH) significantly impacts cardiac output (CO) and cerebral blood flow (CBF) over time. This study reveals a decline in CO and CBF in CH, linked to impaired cardiac function, not just intracranial pressure.

Area of Science:

  • Neuroscience
  • Cardiovascular Physiology
  • Cerebrovascular Research

Background:

  • Decreased cerebral blood flow (CBF) in hydrocephalus is typically attributed to increased intracranial pressure (ICP), ventricular enlargement causing vascular compression, or impaired metabolism.
  • The role of cardiac function and systemic blood flow in chronic hydrocephalus (CH) has been under-explored.
  • Understanding these systemic effects is crucial for a comprehensive view of CH pathophysiology.

Purpose of the Study:

  • To investigate the relationship between the duration and severity of chronic obstructive hydrocephalus (CH) and key hemodynamic parameters.
  • To assess cardiac output (CO), CBF, myocardial tissue perfusion (MTP), and peripheral blood flow (PBF) in an experimental CH model.
  • To explore correlations between hydrocephalus severity, intracranial compliance (ICC), and oxygen delivery to the brain.

Main Methods:

  • Utilized an experimental model of chronic obstructive hydrocephalus in canines.
  • Measured CO, CBF, MTP, and PBF using the microsphere injection method over 16 weeks.
  • Assessed cardiac output via Swan-Ganz thermodilution, and measured intracranial compliance (ICC) and oxygen delivery to the prefrontal cortex (PFC).

Main Results:

  • An initial postoperative reduction in CO, CBF, MTP, and PBF was observed in both CH and control groups, with recovery in controls but continued decline in CH animals.
  • CBF was positively correlated with CO but showed no significant relationship with cerebrospinal fluid (CSF) volume or pressure.
  • Decreased CBF correlated with reduced oxygen in the PFC; decreased CO was inversely related to ventriculomegaly and positively related to increased ICC.

Conclusions:

  • Chronic hydrocephalus exerts a significant influence on cardiac output and cerebral blood flow, particularly in later stages.
  • The observed decline in cardiac function in CH warrants consideration in its pathophysiology and clinical management.
  • Further research is needed to elucidate the mechanisms behind the late deterioration of cardiac function in hydrocephalus.

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