European journal of medical research,
Год журнала:
2022,
Номер
27(1)
Опубликована: Сен. 1, 2022
Abstract
Hydrocephalus
is
a
serious
condition
that
affects
patients
of
all
ages,
resulting
from
multitude
causes.
While
the
etiologies
hydrocephalus
are
numerous,
many
acute
and
chronic
symptoms
shared.
These
include
disorientation
pain
(headaches),
cognitive
developmental
changes,
vision
sleep
disturbances,
gait
abnormalities.
This
collective
group
combined
with
effectiveness
CSF
diversion
as
surgical
intervention
for
types
suggest
various
may
share
common
cellular
molecular
dysfunctions.
The
incidence
rate
pediatric
approximately
0.1–0.6%
live
births,
making
it
Down
syndrome
in
infants.
Diagnosis
treatment
forms
adult
remain
understudied
underreported.
Surgical
interventions
to
treat
hydrocephalus,
though
lifesaving,
have
high
failure.
Previously
tested
pharmacotherapies
resulted
net
zero
or
negative
outcomes
potentially
due
lack
understanding
mechanisms
contribute
development
hydrocephalus.
Very
few
well-validated
drug
targets
been
proposed
therapy;
most
these
within
last
5
years.
Within
50
years,
there
only
incremental
improvements
treatments
has
little
progress
made
towards
prevention
cure.
demonstrates
need
develop
nonsurgical
regardless
etiology.
new
paradigms
relies
heavily
on
investment
researching
requires
concerted
support
patient
advocacy
organizations,
government-
private-funded
research,
biotechnology
pharmaceutical
companies,
medical
device
industry,
vast
network
healthcare
professionals.
Fluids and Barriers of the CNS,
Год журнала:
2022,
Номер
19(1)
Опубликована: Фев. 3, 2022
Abstract
The
glymphatic
hypothesis
proposes
a
mechanism
for
extravascular
transport
into
and
out
of
the
brain
hydrophilic
solutes
unable
to
cross
blood–brain
barrier.
It
suggests
that
there
is
circulation
fluid
carrying
inwards
via
periarterial
routes,
through
interstitium
outwards
perivenous
routes.
This
review
critically
analyses
evidence
surrounding
mechanisms
involved
in
each
these
stages.
There
good
both
influx
efflux
occur
along
routes
but
no
principal
route
outflow
perivenous.
Furthermore,
inflow
unlikely
be
adequate
provide
would
needed
account
solute
efflux.
A
tenet
flow
sweeps
parenchyma.
However,
velocity
any
possible
circulatory
within
too
small
compared
diffusion
effective
movement.
By
comparison
earlier
classical
describing
proposed
entry
parenchyma
across
barrier,
movements
by
diffusion,
partly
near
surfaces
carried
“preferred
routes”
including
perivascular
spaces,
white
matter
tracts
subependymal
spaces.
did
not
suggest
Evidence
still
incomplete
concerning
fate
leaving
brain.
large
proportion
eliminated
from
go
lymph
nodes
before
reaching
blood
proportions
delivered
directly
or
indirectly
CSF
which
then
enters
are
as
yet
unclear.
In
addition,
understood
why
how
absence
AQP4
normally
highly
expressed
on
glial
endfeet
lining
reduces
rates
elimination
delivery
it
remote
sites
injection.
Neither
nor
adequately
explain
move
into,
Features
more
complete
description
discussed.
All
aspects
require
further
study.
Science,
Год журнала:
2023,
Номер
379(6627), С. 84 - 88
Опубликована: Янв. 5, 2023
The
central
nervous
system
is
lined
by
meninges,
classically
known
as
dura,
arachnoid,
and
pia
mater.
We
show
the
existence
of
a
fourth
meningeal
layer
that
compartmentalizes
subarachnoid
space
in
mouse
human
brain,
designated
lymphatic-like
membrane
(SLYM).
SLYM
morpho-
immunophenotypically
similar
to
mesothelial
lining
peripheral
organs
body
cavities,
it
encases
blood
vessels
harbors
immune
cells.
Functionally,
close
apposition
with
endothelial
venous
sinus
permits
direct
exchange
small
solutes
between
cerebrospinal
fluid
blood,
thus
representing
equivalent
arachnoid
granulations.
functional
characterization
provides
fundamental
insights
into
brain
barriers
transport.
European journal of medical research,
Год журнала:
2022,
Номер
27(1)
Опубликована: Сен. 1, 2022
Abstract
Hydrocephalus
is
a
serious
condition
that
affects
patients
of
all
ages,
resulting
from
multitude
causes.
While
the
etiologies
hydrocephalus
are
numerous,
many
acute
and
chronic
symptoms
shared.
These
include
disorientation
pain
(headaches),
cognitive
developmental
changes,
vision
sleep
disturbances,
gait
abnormalities.
This
collective
group
combined
with
effectiveness
CSF
diversion
as
surgical
intervention
for
types
suggest
various
may
share
common
cellular
molecular
dysfunctions.
The
incidence
rate
pediatric
approximately
0.1–0.6%
live
births,
making
it
Down
syndrome
in
infants.
Diagnosis
treatment
forms
adult
remain
understudied
underreported.
Surgical
interventions
to
treat
hydrocephalus,
though
lifesaving,
have
high
failure.
Previously
tested
pharmacotherapies
resulted
net
zero
or
negative
outcomes
potentially
due
lack
understanding
mechanisms
contribute
development
hydrocephalus.
Very
few
well-validated
drug
targets
been
proposed
therapy;
most
these
within
last
5
years.
Within
50
years,
there
only
incremental
improvements
treatments
has
little
progress
made
towards
prevention
cure.
demonstrates
need
develop
nonsurgical
regardless
etiology.
new
paradigms
relies
heavily
on
investment
researching
requires
concerted
support
patient
advocacy
organizations,
government-
private-funded
research,
biotechnology
pharmaceutical
companies,
medical
device
industry,
vast
network
healthcare
professionals.
