Astrocyte dysfunction in hydrocephalus: Neuroinflammation and glymphatic impairment

Hydrocephalus is a common neurological disorder characterized by pathological dilation of the ventricular system. Its pathogenesis involves multiple factors, including cerebrospinal fluid (CSF) dynamic imbalance (encompassing overproduction, circulation obstruction, and impaired absorption) and neuroinflammatory responses. Astrocytes, as core components of the neurovascular unit, mediate CSF transport via their specialized end-foot structures and the glymphatic system formed by perivascular spaces (PVS). Simultaneously, they serve as key effector cells in neuroinflammatory regulation, participating in various disease processes. This article systematically reviews the role of astrocytes in the pathogenesis and progression of hydrocephalus, with a focus on their molecular mechanisms in CSF circulation disorders and neuroinflammatory responses. The aim is to provide novel insights for targeted therapies against hydrocephalus.