Hydrocephalus and the heart: interactions of the first and third circulations.

Hydrocephalus is not always caused by blockage in absorption; it can result from an imbalance in cardiac impulse distribution that can cause a ventriculomegaly in chronic communicating hydrocephalus. Chronic ventriculomegaly may result in cardiac dysfunction, which may beget a pathophysiologic cycle in the elderly. The CSF spaces play a critical role in cardiac impulse absorption: cerebral blood flow may be diminished in CSF disease and enhanced by its manipulation. The interface between the CSF circulatory system and cardiovascular system is based on certain organizing principles, at least one of which appears to be the control and regulation of cardiac impulses that are reaching the brain tissue.