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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...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
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...
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...
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...
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...

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Frontal Disconnection for Treating Mild Malformation of Cortical Development with Oligodendroglial Hyperplasia in Epilepsy (MOGHE) in the Frontal Lobe
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Frontal Disconnection for Treating Mild Malformation of Cortical Development with Oligodendroglial Hyperplasia in Epilepsy (MOGHE) in the Frontal Lobe

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Etiology associated with developing posthemispherectomy hydrocephalus after resection-disconnection procedures.

Jennifer Phung1, Paul Krogstad, Gary W Mathern

  • 1Departments of Neurosurgery and Psychiatry & Biobehavioral Sciences;

Journal of Neurosurgery. Pediatrics
|September 10, 2013
PubMed
Summary

Epilepsy surgery patients developing hydrocephalus were linked to specific causes, not temperature or blood/CSF markers. Etiology, particularly hemimegalencephaly and CNS infection, strongly predicted post-hemispherectomy hydrocephalus risk.

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Modeling Posthemorrhagic Hydrocephalus of Prematurity in Rats
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Modeling Posthemorrhagic Hydrocephalus of Prematurity in Rats

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Frontal Disconnection for Treating Mild Malformation of Cortical Development with Oligodendroglial Hyperplasia in Epilepsy (MOGHE) in the Frontal Lobe
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Published on: August 16, 2024

Modeling Posthemorrhagic Hydrocephalus of Prematurity in Rats
04:12

Modeling Posthemorrhagic Hydrocephalus of Prematurity in Rats

Published on: March 28, 2025

Area of Science:

  • Neurosurgery
  • Pediatric Neurology
  • Nephrology

Background:

  • Hydrocephalus is a potential complication following hemispherectomy for epilepsy.
  • Understanding risk factors is crucial for managing post-surgical outcomes.

Purpose of the Study:

  • To investigate associations between clinical epilepsy variables, maximum daily temperature (Tmax), and blood/cerebrospinal fluid (CSF) findings with hydrocephalus risk after hemispherectomy.
  • To identify specific etiologies linked to post-hemispherectomy hydrocephalus.

Main Methods:

  • A cohort of 79 patients undergoing resection-disconnection hemispherectomy with ventriculostomies was studied.
  • Patients were classified based on the need for CSF shunts, comparing clinical variables, Tmax, and blood/CSF parameters.
  • Multivariate and univariate analyses were performed to identify associated factors.

Main Results:

  • 30% of patients required CSF shunts, with 8% developing late hydrocephalus.
  • Etiology was significantly associated with hydrocephalus; hemimegalencephaly (40%) and CNS infection (100%) had higher shunt rates.
  • Univariate analysis linked elevated Tmax, white blood cell count, decreased CSF protein, and increased CSF red blood cells to hydrocephalus.

Conclusions:

  • Etiology is the primary factor associated with developing hydrocephalus after resection-disconnection hemispherectomy.
  • Mechanisms for hydrocephalus vary by etiology, potentially involving altered CSF bulk flow related to histopathology.