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Figure 1: The hypothesis regarding the genesis of cerebral interstitial fluid impairment. Ventriculomegaly is the result of an imbalance between the architectural forces within the stiffened brain parenchyma of the elderly subjects and the increased amplitude of the cerebrospinal fluid pulse waveform. This causes an imbalance between the hydrostatic and the oncotic forces that leads to ischemic damage and failure of drainage of vasoactive metabolites. We propose that the an interstitial fluid compartment impairment is the final stage of the process and that this may be be associated with the neurodegenerative process leading on to the final clinical spectrum of normal pressure hydrocephalus

Figure 1: The hypothesis regarding the genesis of cerebral interstitial fluid impairment. Ventriculomegaly is the result of an imbalance between the architectural forces within the stiffened brain parenchyma of the elderly subjects and the increased amplitude of the cerebrospinal fluid pulse waveform. This causes an imbalance between the hydrostatic and the oncotic forces that leads to ischemic damage and failure of drainage of vasoactive metabolites. We propose that the an interstitial fluid compartment impairment is the final stage of the process and that this may be be associated with the neurodegenerative process leading on to the final clinical spectrum of normal pressure hydrocephalus