Affiliations: Biological Research Institute, Zulia University,
Maracaibo, Venezuela
Note: [] Correspondence: Orlando J. Castejón, Instituto de
Investigaciones Biológicas, "Drs. Orlando Castejón and Haydée
Viloria de Castejón", Universidad del Zulia, Apartado 526,
Maracaibo, Venezuela. Tel.: +58 261 7414370; E-mail: [email protected];
[email protected]
Abstract: The ultrastructural pathology of cerebral cortex in human
hydrocephalus is described. Cortical biopsies of 17 patients of ages ranging
from 10 days to 21 years old examined in our laboratory are described. Nerve
cells show moderate and severe swelling characterized by dilation of
endoplasmic reticulum canaliculi and perinuclear cistern, edema and
degenerative changes of Golgi apparatus, variable degrees of mitochondrial
swelling, and fragmentation of plasma membrane. The neighboring neuropil
exhibits notable enlargement of extracellular space and signs of synaptic
plasticity and degeneration. The astrocytes display edematous changes and
phagocytic activity. Glycogen rich- and glycogen-depleted astrocytes are
observed. Oligodendroglial cells appear normal in certain cases and in others
show moderate hydropic changes. Numerous myelin figures are observed in some
unidentified nerve cell processes. The capillary wall shows evident signs of
blood-brain barrier dysfunction featured by increased endothelial vesicular and
vacuolar transport, closed and open interendothelial junctions, and in severely
edematous areas thinning and breakdown of capillary basement membrane. The role
of ischemia, oxidative stress, increased calcium concentration, activation of
N-methyl-d-aspartate (NMDA) receptors, and disturbance of ion homeostasis are
discussed in relationship with the fine structural alterations of hydrocephalic
brain parenchyma.
Keywords: Human hydrocephalus, nerve cell damage, synaptic plasticity, synaptic degeneration, reactive glial cells, extracellular space, electron microscopy