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Related Concept Videos

Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
Cerebral Edema l: Introduction01:19

Cerebral Edema l: Introduction

Cerebral edema is a pathological increase in brain water content that disrupts intracranial pressure regulation and impairs neurological function. Because the cranial vault is rigid, even modest increases in tissue volume can compromise cerebral perfusion, distort neural structures, and initiate secondary injury. Cerebral edema develops through four principal mechanisms: vasogenic, cytotoxic, interstitial, and ionic.Vasogenic EdemaVasogenic edema arises from disruption of the blood–brain...
Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
Cytotoxic Edema: Pathophysiology01:21

Cytotoxic Edema: Pathophysiology

Cytotoxic edema is a form of cerebral edema characterized by intracellular swelling of neurons, astrocytes, and other glial cells. It develops when the mechanisms responsible for maintaining ionic gradients across the cell membrane become impaired. Under normal physiological conditions, the sodium–potassium ATPase actively transports sodium ions out of the cell and potassium ions into the cell, preserving osmotic balance and enabling electrical signaling. This pump requires a continuous supply...
Cerebrospinal Fluid01:21

Cerebrospinal Fluid

Cerebrospinal fluid (CSF) is a colorless liquid that flows around the brain and the spinal cord, playing a vital role in the protection, support, and overall function of the central nervous system (CNS). CSF production, circulation, and absorption are tightly regulated processes essential for the brain and spinal cord to function properly.
CSF Production
CSF is produced mainly in the choroid plexus, a network of capillaries and ependymal cells located within the ventricular system of the brain.

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In Vivo Imaging of Cerebrospinal Fluid Transport through the Intact Mouse Skull using Fluorescence Macroscopy
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Changes in intracranial CSF distribution after ETV.

Federico Di Rocco1, David Grevent, James M Drake

  • 1Department of Paediatric Neurosurgery, Necker Enfants Malades Hospital, 156 rue de Vaugirard, 75015 Paris, France.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|May 17, 2012
PubMed
Summary

Endoscopic third ventriculocisternostomy (ETV) effectively reduces ventricular volume and expands subarachnoid spaces in pediatric hydrocephalus. Changes in cerebrospinal fluid (CSF) distribution indicate ETV success.

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In Vivo Imaging of Cerebrospinal Fluid Transport through the Intact Mouse Skull using Fluorescence Macroscopy
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Published on: July 29, 2019

Real-time Iontophoresis with Tetramethylammonium to Quantify Volume Fraction and Tortuosity of Brain Extracellular Space
10:45

Real-time Iontophoresis with Tetramethylammonium to Quantify Volume Fraction and Tortuosity of Brain Extracellular Space

Published on: July 24, 2017

Area of Science:

  • Neurosurgery
  • Pediatric Neurology
  • Medical Imaging

Background:

  • Hydrocephalus is a condition characterized by abnormal accumulation of cerebrospinal fluid (CSF) within the brain's ventricles.
  • Endoscopic third ventriculocisternostomy (ETV) is a surgical procedure to create an opening in the floor of the third ventricle to restore CSF flow.
  • Assessing the efficacy of ETV is crucial for managing pediatric hydrocephalus.

Purpose of the Study:

  • To prospectively analyze changes in CSF distribution following ETV in pediatric hydrocephalus patients.
  • To evaluate the relationship between CSF distribution changes and ETV success rates.

Main Methods:

  • Prospective study involving 22 pediatric hydrocephalus patients undergoing ETV.
  • Preoperative and serial postoperative brain magnetic resonance (MR) imaging.
  • Volumetric analysis of CSF distribution using specialized software.

Main Results:

  • Successful ETV led to a significant progressive reduction in ventricular volumes (up to 76% by day 3, 40% at 6 months).
  • Successful ETV correlated with a marked enlargement of subarachnoid spaces (up to 468% at 6 months).
  • Secondary stoma closure resulted in a return to preoperative CSF distribution patterns.

Conclusions:

  • Post-ETV volumetric changes in ventricles and subarachnoid spaces are reliable indicators of surgical success.
  • Monitoring CSF distribution via MR imaging aids in assessing ETV efficacy in children.