title: The CSF accumulator: its role in the central nervous system and implications for advancing hydrocephalus shunt technology.
abstract: The 'cerebrospinal fluid (CSF) accumulator' plays an important physiological role in the healthy central nervous system as both a shock absorber and regulator of drainage. In the presence of hydrocephalus, this function is compromised by resistance to the flow of CSF. It is further compromised by the placement of a standard shunt which allows only for one-way directional diversion of the fluid. Complications associated with shunt dependency may be a direct consequence of both the condition, and a failure of existing systems to restore the normal accumulator function. This article reviews the pathophysiology of the 'CSF accumulator' as it relates to hydrocephalus and its management, and proposes a biomimetic shunt designed to restore the 'CSF accumulator' toward normal. It is hoped that such a device will support normalization of intracranial pressure and restore an appropriate level of CSF volume in the shunted patient.
authors.affiliation: Pediatric Neurosurgery, St. Christopher's Hospital for Children, Allegheny University of the Health Sciences, Philadelphia, Pa. 19134, USA.
authors.forename: G
authors.initials: G
authors.lastname: Magram
authors.forename: A M
authors.initials: AM
authors.lastname: Liakos
mesh_terms: D000328:Adult; D002555:Cerebrospinal Fluid / Q000502:physiology*; D015170:Cerebrospinal Fluid Pressure / Q000502:physiology*; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects / Q000295:instrumentation; D002648:Child; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation; D004735:Energy Transfer / Q000502:physiology; D018495:Fluid Shifts / Q000502:physiology; D006112:Gravitation; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D006849:Hydrocephalus / Q000134:cerebrospinal fluid / Q000150:complications / Q000601:surgery; D007223:Infant; D008161:Lumbosacral Region; D011187:Posture / Q000502:physiology; D011474:Prosthesis Design / Q000592:standards; D011673:Pulsatile Flow / Q000502:physiology; D013115:Spinal Canal / Q000254:growth & development