Neuroimaging in Pediatric Hydrocephalus

Krishnan, Pradeep; Raybaud, Charles; Palasamudram, Sunitha; Shroff, Manohar

doi:10.1007/s12098-019-02962-z

Cited by 35 publications

(34 citation statements)

References 19 publications

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“…Also important in analyzing the results of this study is the degree of ventricular enlargement which through the use of clinically indicated tapping criteria, demonstrated progressive increases in ventricular size without causing animal mortality. The degree of ventricular enlargement was similar to that seen in premature infants with post-hemorrhagic hydrocephalus (17,18) and those born with congenital hydrocephalus (19,20) who at times develop severe ventriculomegaly.…”

Section: Discussionsupporting

confidence: 69%

Glial Associated Impairment of the Glymphatic System in Experimental Neonatal Hydrocephalus

Vasas¹,

McAllister²,

Eskandari³

2021

Preprint

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Background Changes in aquaporin-4 (AQP4) and glial fibrillary acid protein (GFAP) expression by astrocytes have been observed in several pathologies. It is hypothesized that prolonged exposure to pathologically elevated intracranial pressure (ICP) may be linked to impaired glymphatic pathways. In this study we explore histological consequences of prolonged pressure-induced injury in a feline model of neonatal hydrocephalus through changes in AQP4 and GFAP expression. We discuss the implications this may have in gaining a better understanding of the underlying mechanisms of hydrocephalus (HCP). Methods Using a neonatal feline model, obstructive HCP was induced through kaolin injection into the cisterna magna. Time between injection and intervention via ventricular reservoir placement was used to divide groups into early and late treatment groups. Early and late animals received reservoirs at 1- and 2-weeks post kaolin injection, respectively. Controls underwent sham operations (saline injection instead of kaolin). Animals were sacrificed at 4 months allowing for a chronic treated hydrocephalic model at time of brain harvest. Immunofluorescent staining for GFAP, AQP4 and DAPI was performed on histological brain sections from each group, and densitometry was used to quantify the relative signal of protein expression. Results Hydrocephalus was seen in all animals receiving kaolin injection as demonstrated by magnetic resonance imaging, clinical examination and neurological sequelae. Hydrocephalic animals demonstrated lower levels of perivascular AQP4 expression, increased diffuse AQP4 expression and increased glial scarring of perivascular, ependymal and subependymal spaces. Cerebral microvasculature of early treatment groups demonstrated increased astrocytic processes in the perivascular spaces, while late treatment groups demonstrated increased glial scar formation. Overall, the glymphatic system was severely disrupted in chronic treated hydrocephalus compared to controls. Conclusions Reactive astrogliosis and AQP4 mislocation are evident in early and late reservoir-treated HCP. Glial scarring in the perivascular, ependymal and subependymal spaces concurrent with AQP4 internalization from the perivascular region are prominent in HCP conditions present within the neonatal period. Delay in treatment by 1 week demonstrates quantifiable increases in perivascular and ependymal glial scarring at 4 months of age. Further investigation is needed to correlate glymphatic disruption with impaired CSF absorption and its role in promoting progressive hydrocephalus.

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Section: Discussionsupporting

confidence: 69%

Glial Associated Impairment of the Glymphatic System in Experimental Neonatal Hydrocephalus

Vasas¹,

McAllister²,

Eskandari³

2021

Preprint

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show abstract

“…In the developing world, neonatal infections account for most cases of hydrocephalus, while in developed regions the more commonly seen etiologies of hydrocephalus include parenchymal hemorrhage, congenital aqueduct stenosis, myelomeningocele, and posterior fossa tumors. The prevalence of hydrocephalus has been estimated to be at least 1 in 1000 births [8,9]. Etiologies for hydrocephalus in the pediatric populations can also be generally categorized as either congenital or acquired entities.…”

Section: Hydrocephalus In Childrenmentioning

confidence: 99%

Hydrocephalus and CSF Disorders

Farb

2020

IDKD Springer Series

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“…The role of imaging in pediatric hydrocephalus has recently been reviewed. 31 As described in this review and earlier papers, 32 3D T 1 -weighted and T 2 -weighted images form the essential anatomical sequences, with other sequences supplementing these based on the particular feature of the disease being studied. Although much higher spatial resolution can be achieved at high fields, the loss in SNR at low fields can be retrieved partially by the use of long echo trains in turbo spin-echo sequences due to the long T 2 value of CSF and the very low specific absorption rate intrinsic to low-field MRI.…”

Section: Introductionmentioning

confidence: 96%

“… FIGURE S3 A 3D model of the y‐gradient coil wire pattern designed using the target field method described in Krishnan et al 31 …”

mentioning

confidence: 99%