Pathophysiology of idiopathic normal pressure hydrocephalus (part 1): venous hydrodynamics and compliance

Abstract

This review was made in two parts, the first one talks about the theories are involved in the physiopathology of idiopathic normal pressure hydrocephalus whose importance suggests as one of the main, is the involvement and disturbance in the hydrodynamic system whose components alter the regulatory mechanisms of the homeostasis which are described in the Monroe Kelly law and Windkessel phenomenon. By destabilizing these mechanisms of homeostasis the most affected parameter it’s the mechanism of compliance, this ensures regular forces of systole / diastole creating no fluctuations between them and thus providing adequate cerebral perfusion not fluctuate. Once altered the mechanism of compliance, alterations appear in the hydrodynamic system as the venous pressure increase in the Superior Sagittal Sinus (SSS), affecting the drain of the cerebrospinal fluid (CSF), so the compliance, not just give us a damping system and distribution of the forces and bring an adequate laminar blood flow, it’s also involved in the proper control of the entry and exit of blood flow in the brain and in the proper absorption of CSF and blood flow perfusion cerebral. The limitations in our review have been made by the methodology we used finding the bibliography, those were mainly made using pubmed by the following mesh terms: Normal Pressure Hydrocephalus, Hydrodinamics, Compliance, Phisiopathology, Windkessel.