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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Child's nervous system 10 (1994), S. 151-155 
    ISSN: 1433-0350
    Keywords: Cerebrospinal fluid ; Hydrocephalus ; Choroid plexus ; Arachnoid villi ; Brain parenchyma ; Extracellular space
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hydrocephalus is a complex disease of the brain as a whole, and imbalance between cerebrospinal fluid (CSF) formation and absorption is not the sole mechanism involved in its pathophysiology. In the absence of a lymphatic system in the central nervous system, open communication between CSF and interstitial fluid (ISF) of the brain may contribute to maintaining homeostasis of the brain, keeping the microchemical environment in good balance. Membranes or cell layers separating CSF from ISF of the brain do not provide impermeability, so the CSF communicates with ISF across the ependymal layer and the pial surface of the brain. In contradiction of the classical theory, the CSF one may obtain at the cisterna magna, for instance, is different from the newly formed CSF out of the choroid plexus, because it has been modified by the free communication between CSF and ISF spaces as the CSF descends along the neural axis. Free flow of water and some smaller molecules provides a bidirectional movement of water and other materials, and this must play an important role in brain volume control. The significance of this role should not be overlooked in regard to the pathophysiology of hydrocephalus.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Child's nervous system 5 (1989), S. 356-360 
    ISSN: 1433-0350
    Keywords: Hydrocephalus ; Cerebrospinal fluid flow ; Shunting procedures ; Shunt flow rate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Shunt placement diverting cerebrospinal fluid (CSF) has been the treatment of choice for hydrocephalus for the past several decades. However, the procedure often requires revisions owing to excessive drainage, low CSF flow rates, or infections within the system. With regard to valve pressure, selection of an appropriate valve for a specific patient prior to surgery is not always a simple task. Further, an optimal valve selected at the time of implantation may no longer be appropriate given changing pathophysiological conditions as time passes. It is thus desirable to provide a single valve in which the pressure may be modified when necessary without revision. A programmable pressure valve (designed by Sophysa of France) comes in one model which accommodates different pressure settings obviating revision when pressure changes are needed. Pressure changes can be achieved externally by means of a special magnet which allows precise adjustments in valve pressure to be made through the scalp. The authors introduce the mechanism and describe the cases treated using this valve.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1433-0350
    Keywords: Hydrocephalus ; Cerebrospinal fluid flow ; Shunt flow rate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The shunt flow rate will be greatly influenced by the changing posture of the patient. A newly designed method of assessing shunt flow rate by isotope clearance is described and the results of phantom experiments and clinical data are presented. This method makes it possible to assess shunt flow rates in a variety of postures, such as recumbent, or head raised or as posture changes from recumbent to sitting and eventually to upright. As patients changed from the recumbent to the sitting position, shunt flow rates ceased in some cases. In cases with low flow rates in the recumbent position, shunt flow rate increased with any elevation of the upper half of the body. In many cases, flow rates increased as the patient's position changed from recumbent to sitting and then to the upright position. The results suggest that shunt flow rates vary substantially as postures alter in a patient's daily life.
    Type of Medium: Electronic Resource
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