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Neonatal high pressure hydrocephalus is associated with elevation of pro-inflammatory cytokines IL-18 and IFNgamma in cerebrospinal fluid.
[hydrocephalus with stenosis of the aqueduct of sylvius]
In
human
neonatal
high
pressure
hydrocephalus
(
HPHC
)
,
diffuse
white
matter
injury
and
gliosis
predispose
to
poor
neuro-
developmental
outcome
.
The
underlying
mechanism
for
diffuse
white
matter
damage
in
neonatal
HPHC
is
still
unclear
.
Analogous
to
inflammatory
white
matter
damage
after
neonatal
hypoxemia
/
ischemia
,
we
hypothesized
that
pro-
inflammatory
cytokines
could
be
involved
in
neonatal
HPHC
.
If
so
,
early
anti-
inflammatory
therapy
could
ameliorate
white
matter
damage
in
HPHC
,
before
irreversible
apoptosis
has
occurred
.
In
HPHC
and
control
neonates
,
we
therefore
aimed
to
compare
cerebrospinal
fluid
(
CSF
)
concentrations
of
IL
18
,
IFNgamma
and
sFasL
(
interleukin
18
,
interferon
gamma
and
apoptosis
marker
soluble-
Fas
ligand
,
respectively
)
.
In
neonatal
HPHC
(
n
=
30
)
and
controls
(
n
=
15
)
,
we
compared
CSF
concentrations
of
IL
18
,
IFNgamma
and
sFasL
using
sandwich
ELISA
.
HPHC
was
grouped
according
to
etiology
:
spina
bifida
aperta
(
n
=
20
)
,
aqueduct
stenosis
(
n
=
4
)
,
and
fetal
intra-
cerebral
haemorrhage
(
n
=
6
)
.
Neonatal
control
CSF
was
derived
from
otherwise
healthy
neonates
(
n
=
15
)
,
who
underwent
lumbar
puncture
for
exclusion
of
meningitis
.
In
all
three
HPHC
groups
,
CSF
IL
18
concentrations
were
significantly
higher
than
control
values
,
and
the
fetal
intracranial
haemorrhage
group
was
significantly
higher
than
SBA
group
.
Similarly
,
in
all
HPHC
groups
CSF-IFNgamma
concentrations
significantly
exceeded
the
control
group
.
In
both
HPHC
and
control
neonates
,
CSF
FasL
concentrations
remained
within
the
range
of
reference
values
.
Independent
of
the
pathogenesis
,
neonatal
HPHC
is
associated
with
the
activation
of
the
pro-
inflammatory
cytokines
(
IL
-
18
and
IFNgamma
)
in
the
CSF
,
whereas
CSF
apoptosis
biomarkers
(
sFasL
)
were
unchanged
.
This
suggests
that
anti-
inflammatory
treatment
(
in
addition
to
shunting
)
could
be
helpful
to
preserve
cerebral
white
matter
.
Diseases
Validation
Diseases presenting
"hydrocephalus"
symptom
achondroplasia
alexander disease
canavan disease
congenital toxoplasmosis
harlequin ichthyosis
hirschsprung disease
homocystinuria without methylmalonic aciduria
hydrocephalus with stenosis of the aqueduct of sylvius
krabbe disease
monosomy 21
proteus syndrome
severe combined immunodeficiency
sneddon syndrome
von hippel-lindau disease
wiskott-aldrich syndrome
This symptom has already been validated