Spinal cerebrospinal fluid pathways and their significance for the compensation of kaolin-hydrocephalus.
To study the mechanisms of CSF-outflow in hydrocephalus we used radiological and histological methods to examine pathways of CSF absorption. Two, four and six weeks after occlusion of the cisterna magna by kaolin solution, CSF-dynamics were determined. Direct magnification radiography was used to visualize the outflow of X-ray contrast. Ten rats in each group were sacrificed for histological analysis following ventricular perfusion with marker proteins. ICP was increased to 15 +/- 1 mmHg (mean +/- SD) compared to control animals (7 +/- 2 mmHg) in the four week group. Six weeks following kaolin injection no increase in ICP (6 +/- 1 mmHg) could be demonstrated. Outflow resistance was markedly raised in all animals (1074 +/- 315 mmHg min-1 ml-1) displaying highest values (2160 +/- 960) in the four week group as compared to control animals (504 +/- 71). Cisternography demonstrated blocked cranial absorption and CSF-outflow along lumbosacral nerve roots. Histological examination showed syrinx formation in the cervical and thoracic spinal cord. Marker proteins left the subarachnoid space along thoracic and lumbo-sacral spinal rootlets. The radiological and histological findings and the normalisation of ICP after six weeks at doubled CSF-outflow resistance indicated a recruitment of spinal perineural CSF outflow pathways for the compensation of the disturbed cranial CSF-absorption.
Luedemann
W
W
Department of Neurosurgery, Medical School Hannover, Hannover, Germany.
Kondziella
D
D
Tienken
K
K
Klinge
P
P
Brinker
T
T
Berens von Rautenfeld
D
D
D000818:Animals; D004195:Disease Models, Animal; D006849:Hydrocephalus / Q000134:cerebrospinal fluid* / Q000139:chemically induced / Q000000981:diagnostic imaging; D007427:Intracranial Pressure / Q000502:physiology*; D007616:Kaolin; D011859:Radiography; D051381:Rats; D013116:Spinal Cord / Q000473:pathology / Q000503:physiopathology*
D007616:Kaolin