caa a22 4500 463180895 CHVBK 20180406164838.0 cr unu---uuuuu 170326e20070501xx s 000 0 eng 10.1007/s00381-007-0303-z doi (NATIONALLICENCE)springer-10.1007/s00381-007-0303-z Greitz Dan Department of Neuroradiology, MR Research Center, Karolinska University Hospital, Bldg N8, 171 76, Stockholm, Sweden aut Paradigm shift in hydrocephalus research in legacy of Dandy's pioneering work: rationale for third ventriculostomy in communicating hydrocephalus [Elektronische Daten] [Dan Greitz] Objective: This study aims to question the generally accepted cerebrospinal fluid (CSF) bulk flow theory suggesting that the CSF is exclusively absorbed by the arachnoid villi and that the cause of hydrocephalus is a CSF absorption deficit. In addition, this study aims to briefly describe the new hydrodynamic concept of hydrocephalus and the rationale for endoscopic third ventriculostomy (ETV) in communicating hydrocephalus. Critique: The bulk flow theory has proven incapable of explaining the pivotal mechanisms behind communicating hydrocephalus. Thus, the theory is unable to explain why the ventricles enlarge, why the CSF pressure remains normal and why some patients improve after ETV. Hydrodynamic concept of hydrocephalus: Communicating hydrocephalus is caused by decreased intracranial compliance increasing the systolic pressure transmission into the brain parenchyma. The increased systolic pressure in the brain distends the brain towards the skull and simultaneously compresses the periventricular region of the brain against the ventricles. The final result is the predominant enlargement of the ventricles and narrowing of the subarachnoid space. The ETV reduces the increased systolic pressure in the brain simply by venting ventricular CSF through the stoma. The patent aqueduct in communicating hydrocephalus is too narrow to vent the CSF sufficiently. Springer-Verlag, 2007 Cerebrospinal fluid nationallicence Compliance nationallicence ETV nationallicence Hydrocephalus nationallicence Normal-pressure hydrocephalus nationallicence Pathophysiology nationallicence Pulse pressure nationallicence Child's Nervous System Springer-Verlag 23/5(2007-05-01), 487-489 0256-7040 23:5<487 2007 23 381 https://doi.org/10.1007/s00381-007-0303-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00381-007-0303-z text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Greitz Dan Department of Neuroradiology, MR Research Center, Karolinska University Hospital, Bldg N8, 171 76, Stockholm, Sweden aut NATIONALLICENCE 773 0- Child's Nervous System Springer-Verlag 23/5(2007-05-01), 487-489 0256-7040 23:5<487 2007 23 381 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer