A Hypothesis on the Mechanism of Normal Pressure Hydrocephalus Involving Brain Fluid Interactions: A Mathematical Approach.

OBJECTIVE

Hydrocephalus is a severe disorder characterized by pathological enlargement of the brain ventricles, leading to compression and deformation of brain tissue. The pathophysiological mechanisms underlying some subtypes of hydrocephalus remain poorly understood. Normal pressure hydrocephalus (NPH) continues to be a clinically significant and unresolved issue in elderly care. This study proposes a novel approach to investigate this pathology using mathematical modeling techniques.

METHODS

Using stationary multicomponent poroelasticity equations with physiological boundary conditions, we examine the interactions between brain parenchyma and fluid (including arterial, capillary, venous blood, and interstitial fluid). The model describes these interactions through four specific"interaction coefficients".

RESULTS

Analysis revealed how interaction coefficients govern ventricular wall pressure and displacement. The derived analytical approximations of these relationships provide a foundation for hypothesizing the mechanisms of NPH initiation and development.

CONCLUSIONS

This hypothesis suggests that NPH results from compromised vascular autoregulation, which under normal conditions maintains stable ventricular volume.

SIGNIFICANCE: This work identifies specific interaction parameters that govern transitions between physiological stability and pathological ventricular dilation. These results may assist in refining diagnostic criteria and in developing therapeutic strategies aimed at correcting the condition and treating NPH.