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Related Concept Videos

Anatomy of the Brain: Ventricles01:18

Anatomy of the Brain: Ventricles

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There are hollow fluid-filled cavities known as ventricles deep inside the human brain. There are two lateral ventricles, one in each cerebral hemisphere, and each has three different projections — the anterior, inferior, and posterior horns visible from the lateral side. A thin membrane called the septum pellucidum separates the two lateral ventricles. The slender third ventricle in the diencephalon is connected to each lateral ventricle via a channel called the interventricular foramen.
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Cerebrospinal Fluid01:21

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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.
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The blood drainage from the head and neck is primarily managed by three pairs of veins: the external jugular, internal jugular, and vertebral veins. The external jugular veins drain superficial scalp and face structures, passing over the sternocleidomastoid muscles to empty into the subclavian veins.
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Transcellular Transport of Solutes

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Transcellular transport of solutes is the movement of substances like monosaccharides and amino acids through polarized cells. This transport mechanism is primarily seen in epithelial and endothelial cells aided by membrane transport proteins such as channels and transporters. The tight junctions between these cells confine the membrane proteins to the two sides of the cell. The epithelial cells have distinct apical and basolateral domains. In contrast, the endothelial cells show the luminal...
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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Cranial and Spinal Meninges

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The cranial and spinal meninges are complex protective structures surrounding the central nervous system (CNS), consisting of the brain and spinal cord. These meninges consist of the dura mater, the arachnoid mater, and the pia mater. They protect the CNS, provide structural support, and aid in circulating cerebrospinal fluid (CSF).
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Related Experiment Video

Updated: Nov 11, 2025

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
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[Hydrocephalus].

Shigeki Yamada1

  • 1Department of Neurosurgery, Shiga University of Medical Science.

No Shinkei Geka. Neurological Surgery
|March 25, 2021
PubMed
Summary

Normal-pressure hydrocephalus (NPH) involves cerebrospinal fluid (CSF) buildup without increased intracranial pressure. Specific CSF distribution patterns, like disproportionately enlarged subarachnoid space hydrocephalus (DESH), aid in diagnosing NPH subtypes.

Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Hydrocephalus is characterized by excessive cerebrospinal fluid (CSF) accumulation.
  • Normal-pressure hydrocephalus (NPH) is a chronic form where CSF increases slowly, causing brain deformation without elevated intracranial pressure.
  • NPH is categorized into idiopathic (iNPH), secondary (sNPH), and congenital (cNPH) types.

Purpose of the Study:

  • To differentiate between NPH subtypes based on intracranial CSF distribution.
  • To identify characteristic imaging findings for iNPH, specifically disproportionately enlarged subarachnoid space hydrocephalus (DESH).
  • To describe the effects of shunt surgery on CSF distribution in NPH patients.

Main Methods:

  • Analysis of intracranial CSF distribution patterns in different NPH categories.

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  • Identification of specific imaging features, including Sylvian fissure and basal cistern enlargement and convexity subarachnoid space changes.
  • Observation of post-shunt surgery changes in CSF distribution.
  • Assessment of the flow void sign around the aqueduct on T2-weighted MRI.

    • Main Results:

    • Intracranial CSF distribution differs significantly among iNPH, sNPH, and cNPH.
    • iNPH is associated with enlarged Sylvian fissures and basal cisterns, alongside a decreased convexity subarachnoid space, termed DESH.
    • DESH may result from direct CSF flow between ventricles and basal cisterns.
    • Shunt surgery in NPH leads to ventricular and Sylvian fissure shrinkage and convexity subarachnoid space expansion.
    • A flow void sign around the aqueduct indicates increased CSF movement in most NPH cases.

    Conclusions:

    • Distinct CSF distribution patterns, particularly DESH, are key diagnostic markers for iNPH.
    • Imaging findings can differentiate NPH subtypes and predict shunt surgery outcomes.
    • The flow void sign is a valuable indicator of altered CSF dynamics in NPH.