Another small step toward understanding hydrocephalus.

摘要

I congratulate the authors on a well-executed study of the cerebrospinal fluid (CSF) absorption in a canine model of kaolin-induced hydrocephalus using tritiated H20 absorption into the bloodstream in acute and chronic phases of the condition. It was refreshing to correlate newer findings with our age-old understanding of CSF circulation in mammals. This experiment studied the presumed absorption of CSF via the arachnoid villi, while the major nasal output pathway was surgically blocked. Magnetic resonance imaging confirmed hydrocephalus after suboccipital kaolin injection, and 1 ml tritiated H20 was injected into the subarachnoid spaces at 3 days, 2 weeks, and 12 weeks to assess its concentration in blood up to 48 h afterward. Interestingly, the chronic condition seemed to have the most effect, at least early (<16 h postinjection), whereas less CSF flow is suggested during the earlier stages. This interesting finding raises questions of primary CSF absorption via the arachnoid villi, in the acute conditions of increased intracranial pressure (ICP). Perhaps similar mechanisms for normal pressure hydrocephalus should be considered based on these results.