Reconstitution of the cerebral cortical mantle in shunt-corrected hydrocephalus.

The purpose of this study was to ascertain the sequence of events and the cellular constituents involved in reconstituting the cortical mantle after ventricular shunting. The subjects were severely hydrocephalic adult cats. After insertion of a shunt, the ventricular system rapidly returned to normal size and there was gross reconstitution of the cortical mantle. However, there still remained in the cortical mantle many of the histological changes seen before insertion of the shunt. The effect of hydrocephalus is mainly upon axons in the periventricular white matter. The axons become stretched and finally disrupted, resulting in disintegration of the surrounding myelin. In the absence of axons, remyelination cannot take place. It would seem, therefore, that prompt reversal of hydrocephalus is necessary in order to preserve the anatomical and functional integrity of the brain.