MINI REVIEW article
Front. Neurol.
Sec. Dementia and Neurodegenerative Diseases
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1630286
This article is part of the Research TopicHydrocephalus Volume IIView all 4 articles
Navigating Challenges in Hydrocephalus following Intraventricular Hemorrhage: A Comprehensive Review of Current Evidence
Provisionally accepted
- 1West China Hospital, Sichuan University, Chengdu, China
- 2Xichang People's Hospital, Liangshan, China
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Hydrocephalus following intraventricular hemorrhage (IVH) is a complex neurological condition resulting from cerebrospinal fluid (CSF) circulation disruptions due to intraventricular blood entry. This review synthesizes current evidence on pathophysiology, mechanisms, and treatment strategies. Following IVH, erythrocyte lysis releases hemoglobin and iron, triggering oxidative stress and ferroptosis, while thrombin activation, TGF-β1-mediated fibrosis, inflammatory cascades, and ependymal damage collectively contribute to ventricular enlargement. Key animal models elucidate roles of oxidative stress, cytokines, and complement activation in IVH-induced injury. We highlight evolving insights into CSF absorption pathways and blood metabolite interactions, alongside persistent clinical challenges including delayed diagnosis and therapeutic limitations. Experimental approaches such as thrombolytics, iron chelators, and inflammatory inhibitors show preclinical potential but face significant translational barriers: thrombolytics reduced mortality in the CLEAR III trial yet failed to improve functional outcomes or shunt dependence; iron chelation lacks robust clinical validation; and TGF-β1 inhibition yields conflicting efficacy across models. Future research must address the interplay of blood components, inflammatory mediators, and structural damage, prioritizing biomarker discovery and rigorously validated therapeutic innovation.
Keywords: intraventricular hemorrhage, Hydrocephalus, Cerebrospinal Fluid, Erythrocyte lysis, Thrombin, ependymal damage, Inflammatory Response
Received: 17 May 2025; Accepted: 04 Aug 2025.
Copyright: © 2025 Wang, Chen, You, Wu and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tong Sun, West China Hospital, Sichuan University, Chengdu, China
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