Which Came First: Ventricular Enlargement or Abnormal CSF Circulation?

Motivation: Hydrocephalus involves ventricular enlargement and abnormal CSF circulation. Determining their sequence is crucial for understanding pathogenesis and improving diagnosis. Goal(s): Validate that area ratio of lateral ventricles to brain (Ratio-Area) and stroke volume ratio of aqueduct to spinal canal (Ratio-SV) are reliable markers, and explore the pathogenesis of communicating hydrocephalus. Approach: Thirty-six healthy volunteers underwent MRI to extract morphological and fluid dynamics parameters, analysing correlations among aqueduct Resistance, Ratio-Area, and Ratio-SV. Results: Ratio-Area and Ratio-SV eliminate the influence of heart rate, CSF volume, and brain volume differences. No correlation between Ratio-Area and Ratio-SV, while Resistance showed a strong correlation with Ratio-SV. Impact: The findings provide insights into the pathogenesis of hydrocephalus, offering potential markers for early diagnosis. Understanding the relationship between aqueduct resistance, Ratio-SV, and Ratio-Area may guide clinical practice and help identify early indicators of CSF dynamic disorders.