Hydrocephalus Pathophysiology and Epidemiology

Abstract

Adult hydrocephalus is a common neurologic condition with an estimated prevalence of 85 per 100,000 globally, caused by abnormal cerebrospinal fluid (CSF) accumulation within the cerebral ventricles. Subtypes include idiopathic normal pressure hydrocephalus, posthemorrhagic, postinfectious, posttraumatic, and tumor-associated forms. Its pathophysiology involves glymphatic dysfunction, neuroinflammation, vascular compromise, and impaired CSF absorption. Despite advances in treatment, significant gaps remain in understanding its epidemiology, particularly in regards to regional variability and comorbidities, alongside unresolved questions about glymphatic pathways and neurodegenerative overlap. Standardized diagnostic and therapeutic frameworks are urgently needed.

Keywords: Blood–CSF barrier disruption; Cerebrospinal fluid dynamics; Epidemiology of hydrocephalus; Glymphatic dysfunction; Neuroinflammation; Posthemorrhagic hydrocephalus.