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Article
May 1970

Structural, Ultrastructural, and Permeability Changes in the Ependyma and Surrounding Brain Favoring Equilibration in Progressive Hydrocephalus

Author Affiliations

Bethesda, Md
From the Branch of Surgical Neurology, National Institute of Neurological Diseases and Stroke, Bethesda, Md (Drs. Milhorat and Hammock), Department of Neurosurgery, the New York Hospital-Cornell Medical Center, New York (Dr. Milhorat), and Laboratory of Pathology, Division of Biological Standards, National Institutes of Health, Bethesda, Md (Dr. Clark and Mr. McGrath).

Arch Neurol. 1970;22(5):397-407. doi:10.1001/archneur.1970.00480230015002
Abstract

IT HAS recently been shown1 that following effective obstruction of the fourth ventricle and caudal aqueduct, hydrocephalus develops as an acute, rapidly progressive process. The initial rate of progression is precipitous, and within a few hours the hydrocephalic changes are advanced. Thereafter, the rate of ventricular enlargement slows abruptly and continues to decrease until a moderate, stable, and chronically progressive rate is established.

Within hours of complete ventricular obstruction, a number of changes, developing in response to acute ventricular enlargement, are seen in the ependyma and surrounding brain.2 The changes are severe and are probably accompanied by a diffuse alteration in the permeability of the ventricular surface.3 It was noted that once these changes are well established, the rate of ventricular enlargement slows perceptibly.

The current paper reports some further observations on the structural and permeability changes of the ventricular surface in acute obstructive hydrocephalus. The

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