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Instituto Nacional de Neurología y Neurocirugía

2016, Número 1

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Arch Neurocien 2016; 21 (1)


Fisiopatología de la hidrocefalia idiopática de presión normal (parte 2): flujo sanguíneo cerebral, isquemia de la sustancia blanca profunda

Solís SO, Ayala GM, López PJL

Idioma: Español
Referencias bibliográficas: 56
Paginas: 55-63
Archivo PDF: 322.52 Kb.


RESUMEN

En el desarrollo de la hidrocefalia idiopática de presión normal (HIPN), existen múltiples factores involucrados para que se establezca la enfermedad, uno de estos que la literatura mas apoya es la alteración en el flujo sanguíneo cerebral y la isquemia de la sustancia blanca profunda, estas modificaciones pueden ser originadas por eventos previos de una enfermedad cerebrovascular, angiopatía amiloidea, y arterias medulares (arterias perforantes de la sustancia blanca profunda) escleróticas. Mirando estos cambios detenidamente veremos que por lo general son regionales y que se acentúan principalmente en los vasos de los ganglios basales y periventriculares (sustancia blanca profunda). A su vez, estos cambios en el flujo regional traerán consecuencias como edema, acumulación de productos de desecho como el beta-amiloide (βa), contribuyendo a una hipoxia crónica. Una de las preguntas que más se pueden discutir en este tema es sobre si los cambios en el flujo sanguíneo son la causa de estos transtornos o simplemente son un epifenómeno. Otros autores mencionan que otro factor simultáneo a la falla del desecho de productos tóxicos como el β-amiloide, son daños a la Unidad Neurovascular (UNV), este daño es con frecuencia visto en la enfermedad de Alzheimer y de ahí una de las razones por las cuales existe una comorbilidad con la HIPN.


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