低压性脑积水的探讨?低压性脑积水的探讨李小勇搞清脑积水定义是认识各种脑脊液疾病的基础理论。可以直接翻译成：“脑积水是脑室系统的主动扩张，原因是脑脊液通路不畅”。为什么一个母语为英语的脑积水专家会发表如此的对象描述不明确的现象呢？要说明这个“主动”的所致，必须要首先理解这些术语之间的因果关系。脑积水定义，其实涉及到了三个概念：脑脊液，脑室（系统）即容纳脑脊液的空间，以及作为固体部分的脑实质。
低压性脑积水的探讨?李小勇搞清脑积水定义是认识各种脑脊液疾病的基础理论以往比较经典的脑积水定义有两种类型，分别针对的是脑脊液和脑室（系统）的行为，如：1、Ventricular enlargement due to altered CSF flow or resorption （因为脑脊液流动或吸收的变化而引起的脑室扩大）；2、Hydrocephalus is a condition in which there is an accumulation of cerebrospinal fluid (CSF) within the brain.[1] （脑室内脑脊液蓄积的过程或状态）（注：没有叙述引起脑脊液蓄积的原因，根据上一定义或学者一般只是可以自然知道是脑脊液的循环受阻），今天小编就来说说关于低压性脑积水的探讨?下面更多详细答案一起来看看吧!
低压性脑积水的探讨
李小勇
搞清脑积水定义是认识各种脑脊液疾病的基础理论。以往比较经典的脑积水定义有两种类型，分别针对的是脑脊液和脑室（系统）的行为，如：1、Ventricular enlargement due to altered CSF flow or resorption （因为脑脊液流动或吸收的变化而引起的脑室扩大）；2、Hydrocephalus is a condition in which there is an accumulation of cerebrospinal fluid (CSF) within the brain.[1] （脑室内脑脊液蓄积的过程或状态）（注：没有叙述引起脑脊液蓄积的原因，根据上一定义或学者一般只是可以自然知道是脑脊液的循环受阻）。
Harold L Rekate教授，是美国凤凰城圣若瑟医院和医学中心Barrow 神经病学研究所儿科神经科学部中一位行医48年的教授，发表的题为“A Contemporary Definition and Classification of Hydrocephalus”的论述无疑对脑积水的概念具有很大的学术影响力，因为一直没有被公认是好的脑积水定义。他提出的定义采用的是第一种类型：“hydrocephalus is an active distension of the ventricular system of the brain related to inadequate passage of CSF from its point of production within the ventricular system to its point of absorption into the systemic circulation”。可以直接翻译成：“脑积水是脑室系统的主动扩张，原因是脑脊液通路不畅 ”。这个翻译没有违背作者的原意或所表达的概念，但是读者却不知道“主动（active）”指的是“谁”的行为？是脑脊液的，还是脑室的？为什么一个母语为英语的脑积水专家会发表如此的对象描述不明确的现象呢？说明在美国，至少可以说，美国也没有很多深入于脑脊液学科研究的学者，也不是专职于脑脊液疾病的“业余”学者。要说明这个“主动（active）”的所致，必须要首先理解这些术语之间的因果关系。脑积水定义，其实涉及到了三个概念：脑脊液，脑室（系统）即容纳脑脊液的空间，以及作为固体部分的脑实质。
定义“Hydrocephalus is a condition in which there is an accumulation of cerebrospinal fluid (CSF) within the brain.[1] ”，所讨论的是脑脊液和脑实质两者，或脑脊液，脑室（系统）和脑实质三者之间的因果关系问题，如果将“主动（active）”植入此定义中，可以是“Hydrocephalus is a condition in which there is an active accumulation of cerebrospinal fluid (CSF) within the brain”的形式，表现的是相对于脑实质或相对于脑室而言的“主动（active）”，因此可以理解为脑室扩大是被动的（passive），而不是主动的。
此新的定义““hydrocephalus is an active distension of the ventricular system of the brain.... ”中，按脑脊液循环原理分析，应讨论的是脑室（系统）和脑实质两者之间的关系，省去了脑脊液这个更早的“主动（active）”的概念或含义，所以，要理解或准确翻译这个新的定义，还需要具备定义之外的一些脑脊液科基础知识，其实如果将此定义加上脑脊液的内容，可能才更好理解“hydrocephalus is an active distension of（ CSF in ）the ventricular system of the brain related to inadequate passage of CSF from its point of production within the ventricular system to its point of absorption into the systemic circulation”。翻译成“脑积水是脑室系统内脑脊液的主动扩张，原因是脑脊液通路不畅 ”，才更容易理解。
关于脑脊液主动扩张的概念，又是另一个“脑脊液是什么”的新学术问题：脑脊液是物体，还是其内的成分？还是两者兼有的概念？有待以后论述。如上讨论，是本人的个人观点，不对之处，欢迎指正和批评。
附： 脑积水的定义：其中的active是什么意思？如何翻译成汉语？
hydrocephalus is an active distension of the ventricular system of the brain related to inadequate passage of CSF from its point of production within the ventricular system to its point of absorption into the systemic circulation.
A Contemporary Definition and Classification of Hydrocephalus
Author links open overlay panelHarold L.RekateMD
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http://doi.org/10.1016/j.spen.2009.01.002Get rights and content
This review focuses on the problems related to defining hydrocephalus and on the development of a consensus on the classification of this common problem. Such a consensus is needed so that diverse research efforts and plans of treatment can be understood in the same context. The literature was searched to determine the definition of hydrocephalus and to identify previously proposed classification schemes. The historic perspective, purpose, and result of these classifications are reviewed and analyzed. The concept of the hydrodynamics of cerebrospinal fluid (CSF) as a hydraulic circuit is presented to serve as a template for a contemporary classification scheme. Finally, a definition and classification that include all clinical causes and forms of hydrocephalus are suggested. The currently accepted classification of hydrocephalus into “communicating” and “noncommunicating” varieties is almost 90 years old and has not been modified despite major advances in neuroimaging, neurosciences, and treatment outcomes. Despite a thorough search of the literature using computerized search engines and bibliographies from review articles and book chapters, I identified only 6 previous attempts to define and classify different forms of hydrocephalus. This review proposes the following definition for hydrocephalus: hydrocephalus is an active distension of the ventricular system of the brain related to inadequate passage of CSF from its point of production within the ventricular system to its point of absorption into the systemic circulation. Based on this definition (potential points of flow restriction) and on the view of the CSF system as a hydraulic circuit, a classification system is proposed. The acceptance of this proposed definition and classification schema would allow clinicians and basic scientists to communicate effectively, to share information and results, and to develop testable hypotheses.
