Abstract
The breakdown of the ventricular zone (VZ) with the presence of blood in
cerebrospinal fluid (CSF) has been shown to increase shunt catheter
obstruction in the treatment of hydrocephalus, but the mechanisms by
which this occurs are generally unknown. Using a custom-built incubation
chamber, we immunofluorescently assayed cell attachment and morphology
on shunt catheters with and without blood after 14 days. Samples exposed
to blood showed significantly increased cell attachment (average total
cell count 392.0±317.1 versus control of 94.7±44.5,P <0.0001). Analysis of the glial fibrillary acidic
protein (GFAP) expression showed similar trends (854.4±450.7 versus
control of 174.3±116.5, P <0.0001). An in vitromodel was developed to represent the exposure of astrocytes to blood
following an increase in BBB permeability. Exposure of astrocytes to
blood increases the number of cells and their spread on the shunt.