Histology of Hydrocephalus
Linking Structure to Pathophysiology
Key Structures Involved
• Ependymal lining – cilia circulate CSF
• Choroid plexus – produces CSF
• Brain vascular system – water balance (AQP4)
• Glial lymphatic system – clears CSF
• Meninges & arachnoid villi – absorb CSF
Pathology in Hydrocephalus
• Cilia dysfunction → poor CSF flow
• Overproduction of CSF → accumulation
• AQP4 dysregulation → edema
• Fibrosis / infection → impaired absorption
• Inflammation & gliosis → barrier damage
Convergent Mechanisms
• Too much CSF production
• Blocked CSF circulation
• Reduced clearance
• Inflammation & fibrosis
• Junction breakdown
Emerging Therapies
• Reduce inflammation
• Repair fibrosis
• Restore ciliary function
• Improve glymphatic clearance
• Regulate CSF production
Mnemonic: 'FLOW'
F – Fibrosis repair
L – Lymphatic clearance (glymphatic)
O – Overproduction control
W – Water channel (AQP4) regulation
