Rubin R C, Hochwald G M, Tiell M, Epstein F, Ghatak N, Wisniewski H
Surg Neurol. 1976 Mar;5(3):179-83.
Adult cats with hydrocephalus were sacrificed at varying times following valveless ventricular shunting. This shunting resulted in a prompt reduction of ventricular size and rapid gross reconstitution of cortical mantle. Ultrastructurally it was evident that white matter edema persisted for many weeks, even in the presence of normal size ventricles. The areas most severely affected by the hydrocephalus such as the corpus callosum showed a paucity of myelinated fibers and their replacement by numerous reactive astrocytes. Reconstitution of the cortical mantle consists predominantly of a diminution of white matter edema and reactive astrocytosis. Clinical improvement undoubtly results from the functional improvement of remaining elements rather than from the replacement of lost elements. This scheme of hydrocephalus suggests that if hydrocephalus is relieved when only ependymal disruption and periventricular water accumulation have occurred, it may be reversible. The subsequent sequence of events consisting of axonal degeneration, myelin disruption and reactive astrocytosis may be less, if at all reversible.
在进行无瓣膜脑室分流术后的不同时间，对患有脑积水的成年猫实施安乐死。这种分流术使脑室大小迅速减小，皮质被膜在大体上快速重建。超微结构显示，即使脑室大小恢复正常，白质水肿仍持续数周。受脑积水影响最严重的区域，如胼胝体，显示出有髓纤维数量减少，并被大量反应性星形胶质细胞取代。皮质被膜的重建主要包括白质水肿减轻和反应性星形细胞增生减少。临床改善无疑是由于剩余结构的功能改善，而非丢失结构的替代。这种脑积水模式表明，如果在仅发生室管膜破坏和脑室周围积水时解除脑积水，可能是可逆的。随后由轴突退变、髓鞘破坏和反应性星形细胞增生组成的一系列事件，即便有可逆性，程度可能也较小。
