Department of Neurosurgery, Monash Health, 246 Clayton Road, Clayton, Melbourne, VIC, 3168, Australia.
Department of Surgery, Monash University, Melbourne, Australia.
Neurosurg Rev. 2022 Feb;45(1):305-315. doi: 10.1007/s10143-021-01622-1. Epub 2021 Aug 14.
Hydrocephalus is the symptomatic endpoint of a variety of disease processes. Simple hydrodynamic models have failed to explain the entire spectrum of cerebrospinal fluid (CSF) disorders. Physical principles argue that for ventricles to expand, they must be driven by a force, Fishman's transmantle pressure gradient (TMPG). However, the literature to date, reviewed herein, is heterogenous and fails to consistently measure a TMPG. The venous system, like CSF, traverses the cerebral mantle, and thus analogous transparenchymal and transvenous pressure gradients have been described, reliant on the differential haemodynamics of the deep and superficial venous systems. Interpreting CSF disorders through these models provides new insights into the possible pathophysiological mechanisms underlying these diseases. However, until more sophisticated testing is performed, these models should remain heuristics.
脑积水是多种疾病过程的症状终点。简单的流体动力学模型未能解释整个脑脊液（CSF）紊乱谱。物理原理认为，脑室要扩张，就必须有一个力驱动，这就是 Fishman 的脑膜间压力梯度（TMPG）。然而，迄今为止的文献综述表明，这方面的研究存在异质性，并且未能一致地测量 TMPG。静脉系统与 CSF 一样穿过脑皮质，因此类似于穿过脑实质和穿过静脉的压力梯度已经被描述出来，这依赖于深部和浅部静脉系统的不同血液动力学。通过这些模型来解释 CSF 紊乱为这些疾病的可能病理生理机制提供了新的见解。然而，在进行更复杂的测试之前，这些模型应该仍然只是启发式的。
