Influence of atrophic hydrocephalus on subarachnoid space

Hydrocephalus in medical practice is characterized as a dropsy in the brain. This condition indicates excessive accumulation of cerebrospinal fluid in the cerebral cavity.

Normally, there is a constant circulation of the CSF. The substance in the spinal cord and brain is washed on all sides by a transparent, colorless liquid, which has various properties, the main of which are protection and provision of additional nutrition. External circulation of cerebrospinal fluid occurs between the vascular and soft membranes throughout the entire surface of the hemispheres and the cerebellum. This surface is called the subarachnoid space. In the cranial base under the brain there are several more areas of fluid accumulation. They are called cisterns. These areas, connecting with each other in different directions, form a cerebral subarachnoid space in the brain and connect to a similar surface in the spinal cord.

In the latter, there is no system of canals and a protective-trophic system of cells. The subarachnoid space in the spinal cord behind the posterior roots has a dense skeleton consisting of fibrous fibers intertwined with each other. It should be noted that there are plexuses only here. The lateral subarachnoid space of formations between the dentate ligament and the posterior rootlets does not. Front between the soft and arachnoid shells are collagen beams, which do not create obstacles for the circulation of the cerebrospinal fluid.

Atrophic hydrocephalus is a neglected trauma by the passive process of replacing the brain substance that decreases in volume with the cerebrospinal fluid. The condition is characterized by a simultaneous and, as a rule, a symmetrical increase in the ventricles. In this case, basal cisterns and subarachnoidal convective spaces are expanded against the background of absence of periventricular edema.

Atrophic hydrocephalus is based on a diffuse process of atrophic nature. Demyelination caused by primary brain damage leads to a decrease in both gray and white matter.

The first manifestations of atrophic hydrocephalus can be detected after two or four weeks after CCT (craniocerebral trauma). In the subsequent there is either a prolonged progression of the process, or its stopping.

Specialists classify a mild, moderate or severe form of the disease.

In the first case, there is a moderate cerebral atrophy, in which there is a slight expansion in subarachnoid grooves and cracks - one or two millimeters, as well as in the ventricular system.

The average degree of the disease is characterized by more significant changes - an expansion in the subarachnoid grooves and cracks by three to four millimeters. In addition, a widespread decrease in density in the brain tissue of a moderate nature is possible.

The severe degree of the disease is marked by a significant expansion in the ventricular system (CRI more than 20.0), in subarachnoid grooves and cracks - over four millimeters. In addition, there is a generalized decrease in density in the brain tissue.

It should be noted that the morphological severity and clinical manifestations of atrophic hydrocephalus are not parallel.

Accurate diagnosis is performed using CT and MRI. Simultaneous and symmetric expansion of the subarachnoid space in combination with an increase in the cerebral ventricles, the absence of periventricular edema, no doubt, speak in favor of atrophic hydrocephalus.

In the early stages of the development of the disease, it is often possible to form a sufficient and stable compensation of the patient's condition. However, at a stage of the disease that has gone far, the prognosis is very unfavorable.