Scientific Report 2003-2004 - Cleveland Clinic Lerner Research ...

The Department of NeurosciencesCerebral Blood Flow, Shunting Examinedin Chronic Hydrocephalus ResearchCombined efforts in clinical medicine andbasic research are being used to investigatethe pathophysiology, diagnosis, andtreatment of chronic hydrocephalus. Compellingevidence from our laboratory, as well as others,suggests that brain hypoxia, through vesselcompression, may play an important role in thispreventable neurological injury. Our directobjective is to understand cerebrovascularresponse to ventricular enlargement, optimizecurrent treatment such as cerebrospinal fluid(CSF) shunting, and develop new techniques and/or methods to alleviate symptoms related tochronic hydrocephalus.Recently Dr. Luciano has been awarded afour-year; NIH-R01 grant entitled “CerebralBlood Flow Response to Chronic Hydrocephalus.”Using a canine model developed in ourlaboratory, we are able to study the pathophysiol-ogy of chronic hydrocephalus by measuringventricular size and pressure, and their relationshipto histological changes, cerebral blood flow(CBF) and oxygen delivery to the brain. Regionalchanges in CBF will be studied with microsphereinjection technique and patterns of oxygendelivery by measuring brain and CSF oxygensaturation. The mechanisms of CBF changes andtheir effect on CNS tissue are studied throughquantitative histological examination of thecerebrovascular morphology and neural parenchyma.This study focuses on the naturalprogression of chronic hydrocephalus and theeffect of surgical treatment (CSF shunting) onthe vascular response of early and late shunting tonon-hydrocephalic animals and untreated animals.We hope to expand our understanding of chronichydrocephalus through basic research and applythis knowledge in clinical medicine.THE LUCIANOLABORATORYRESEARCH ASSOCIATEStephen Dombrowski, Ph.D,Director of PCNS ExperimentalStudiesPostdoctoral FellowsSamer Elbabaa, M.D.Zhicheng Li, M.D.Mark Luciano, M.D.,Ph.D.Director,PCNS and Cleveland Clinic Hydrocephalus ProjectJohnson, M.J., Ayzman, I., Wood, A.S., Tkach, J.A., Klauschie, J., Skarupa, D.J., McAllister, J.P., andM.G. Luciano (1999) Development and characterization of an adult model of obstructive hydrocephalus. J.Neurosci. Methods 91:55-65.Luciano, M.G., Skarupa, D.J., Booth, A.M., Wood, A.S., Brant, C.L., and M.J. Gdowski (2001) Cerebrovascularadaptation in chronic hydrocephalus. J. Cereb. Blood Flow Metab. 21:285-294.Fukuhara, T., Luciano, M.G., Brant, C.L., and J. Klauscie (2001) Effects of ventriculoperitoneal shunt removalon cerebral oxygenation and brain compliance in chronic obstructive hydrocephalus. J. Neurosurg.94:573-581.Fukuhara, T., Luciano, M.G., and R.J. Kowalski (2002) Clinical features of third ventriculostomy failuresclassified by fenestration patency. Surg. Neurol. 58:102-110.139