Takei F, Shapiro K, Oi S, Sato O
Department of Neurosurgery, Tokai University School of Medicine, Kanagawa, Japan.
Acta Neurochir Suppl (Wien). 1994;60:577-81. doi: 10.1007/978-3-7091-9334-1_160.
The efficacy of shunting the hydrocephalic edema was evaluated by means of transmission electromicroscopical observation (TEM) comparing ultrastructural alterations seen in either valid or invalid shunted feline hydrocephalus. Owning to shunt placement, deteriorated clinical symptoms recovered and one of the observed morphological alterations such as gliosis developed chronologically after the initiation of hydrocephalus. On the other hand, so called hydrocephalic edema observed in the region of periependymal tissue after shunt placement was improved not only in both valid and invalid shunted but also even in sham group however the extent of these alterations were different from each other. Among such observation, a distinct chronological linkage between the morphological alterations and clinical outcome was not noted. Our conclusions in present study were 1) shunt implantation results in the promotion of gliosis in the region of periventricular tissue in spite of the expected efficacy of shunt, 2) recovery of hydrocephalic edema was influenced not only by effective shunt implantation but also by the processes in chronological tissue reconstructions occurred in the natural course of hydrocephalus, and 3) early treatment of periventricular edema in hydrocephalus through shunting corrects the ill-fated neuro axis environments and reforming the intracranial conditions such as normalizing ICP and relieving hemodynamic distress seems to be more important than morphological recovery in treating hydrocephalus.
