1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-20-83-a 10.15844/pedneurbriefs-20-11-3 Congenital Developmental Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant CSF Obstruction and Malabsorption in Congenital Hydrocephalus http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 11 2006 01 02 2016 20 11 83 83 Copyright: © 2006 The Author(s) 2006 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Cerebrospinal fluid obstruction and malabsorption in human neonatal hydrocephaly

The relative contribution of CSF malabsorption and obstruction in three different etiological groups of neonatal high-pressure hydrocephalus (HC) was assessed in a study at University of Bonn, Germany, and University of Groningen, The Netherlands.

 High-Pressure Hydrocephalus Malabsorption Spina Bifida

The relative contribution of CSF malabsorption and obstruction in three different etiological groups of neonatal high-pressure hydrocephalus (HC) was assessed in a study at University of Bonn, Germany, and University of Groningen, The Netherlands. CSF biomarkers, transforming growth factor beta-1 (TGF B-l), and aminoterminal propeptide of type 1 collagen (PC1NP), indicative of growth factor- and fibrosis-related CSF malabsorption, were assessed and compared in neonates with post-hemorrhagic HC (n=6), non-hemorrhagic triventricular HC (n=4) and spina bifida (SB) HC (n=12). CSF interleukin-6 (IL-6) cytokines, indicative of inflammation, were low and did not differ between groups. TGF B-l concentrations were significantly higher in post-hemorrhagic HC cases (median 355 pg/ml) than in SB HC (median 103) and non-hemorrhagic HC (median 120); p=0.01 and 0.03, respectively. Median CSF PC1NP concentrations were significantly lower in SB HC (180 ng/ml) than in post-hemorrhagic HC (1,060 ng/ml); p=0.002. Neonatal posthemorrhagic HC is associated with high concentrations of CSF malabsorption-related biomarkers whereas SB and non-hemorrhagic HC have lower concentrations, indicating that CSF obstruction contributes more to the development of these cases than malabsorption. [1]

COMMENT. High TGF B-l and PC1NP CSF concentrations in neonatal post-hemorrhagic HC are indicative of a fibrosis-related malabsorption as the cause of the HC, contrasting with relatively low levels of malabsorption biomarkers in SB and non-hemorrhagic triventricular HC. CSF obstruction, rather than malabsorption, plays a major role in the pathogenesis of high-pressure SB and non-hemorrhagic HC.

Heep A Bartmann P Stoffel-Wagner B Bos A Hoving E Brouwer O Cerebrospinal fluid obstruction and malabsorption in human neonatal hydrocephaly Childs Nerv Syst 2006 Oct 22 10 1249 1255 10.1007/s00381-006-0102-y 16699804