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Chapter 25 - Hydrocephalus
- from Section 2 - Clinical Neurosurgical Diseases
- Edited by Farhana Akter, Harvard University, Massachusetts, Nigel Emptage, University of Oxford, Florian Engert, Harvard University, Massachusetts, Mitchel S. Berger, University of California, San Francisco
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- Book:
- Neuroscience for Neurosurgeons
- Published online:
- 04 January 2024
- Print publication:
- 25 January 2024, pp 335-347
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Summary
Hydrocephalus affects 1/1000 births and is treated using neurosurgical cerebrospinal fluid(CSF) diversion techniques with high complication and failure rates. Recent data on the pathogenesis of acute post-hemorrhagic hydrocephalus(PHH) have implicated an acute Toll-like receptor(TLR4)-dependent hypersecretory response of the choroid plexus epithelium(CPe), the site of highly regulated CSF production and part of the blood–CSF barrier. Post-infectious hydrocephalus(PIH) is the most common form of hydrocephalus worldwide and shares multiple features with PHH, including TLR4-regulated CSF cytokines and immune cells. We introduce the concept of “inflammatory hydrocephalus”, and argue this may more precisely convey the shared pathogenic mechanisms and potential therapeutic vulnerabilities of PHH/PIH than the current concept of “secondary hydrocephalus.” This change of emphasis could shift our view of PHH/PIH from that of lifelong neurosurgical disorders to one of preventable neuroinflammatory conditions. In addition to attenuating acute CPe hypersecretion, early targeting of TLR4 may prevent inflammation-induced brain damage resulting in scarring, obstruction, and poor long-term neurodevelopmental outcomes.
Contributors
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- By Magdalena Anitescu, Charles E. Argoff, Arash Asher, Nyla Azam, Nomen Azeem, Sachin K. Bansal, Jose E. Barreto, Rodrigo A Benavides, Niteesh Bharara, Justin B. Boge, Robert B. Bolash, Thomas K. Bond, Christopher Centeno, Zachariah W. Chambers, Jonathan Chang, Grace Chen, Hamilton Chen, Jeffry Chen, Jianguo Cheng, Natalia Covarrubias, Claire J. Creutzfeldt, Gulshan Doulatram, Amirpasha Ehsan, Ike Eriator, Jeff Ericksen, Mark Etscheidt, Frank J. E. Falco, Jack Fu, Timothy Furnish, Annemarie E. Gallagher, Kingsuk Ganguly, Eugene Garvin, Cliff Gevirtz, Scott E. Glaser, Brandon J. Goff, Harry J. Gould, Christine Greco, Jay S. Grider, Maged Guirguis, Qiao Guo, Justin Hata, John Hau, Garett J. Helber, Eric R. Helm, Lori Hill Marshall, Dean Hommer, Jeffrey Hopcian, Eric S. Hsu, Jakun Ing, Tracy P. Jackson, Gaurav Jain, Chrystina Jeter, Alan David Kaye, James Kelly, Soorena Khojasteh, Ankur Khosla, Daniel Krashin, Monika A. Krzyzek, Prasad Lakshminarasimhiah, Steven Michael Lampert, Garrett LaSalle, Quan D. Le, Ankit Maheshwari, Edward R. Mariano, Joaquin Maury, John P. McCallin, John Michels, Natalia Murinova, Narendren Narayanasamy, Rebekah L. Nilson, Elliot Palmer, Vikram B. Patel, Devin Peck, Donald B. Penzien, Danielle Perret Karimi, Tilak Raj, Michael R. Rasmussen, Mohit Rastogi, Rahul Rastogi, Nashaat N. Rizk, Rinoo V. Shah, Paul A. Sloan, Julian Sosner, A. Raj Swain, Minyi Tan, Natacha Telusca, Santhosh A. Thomas, Andrea Trescot, Michael Truong, Jason Tucker, Richard D. Urman, Brandon A. Van Noord, Nihir Waghela, Irene Wu, Jiang Wu, Jijun Xu, Jinghui Xie, William Yancey
- Edited by Alan David Kaye, Louisiana State University, Rinoo V. Shah
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- Book:
- Case Studies in Pain Management
- Published online:
- 05 October 2014
- Print publication:
- 16 October 2014, pp xi-xv
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