The breakdown of the ventricular zone (VZ) with the presence of blood in
cerebrospinal fluid (CSF) has been shown to increase shunt catheter
obstruction in the treatment of hydrocephalus, but the mechanisms by
which this occurs are generally unknown. Using a custom-built incubation
chamber, we immunofluorescently assayed cell attachment and morphology
on shunt catheters with and without blood after 14 days. Samples exposed
to blood showed significantly increased cell attachment (average total
cell count 392.0±317.1 versus control of 94.7±44.5, P<0.0001).
Analysis of the glial fibrillary acidic protein (GFAP) expression showed
similar trends (854.4±450.7 versus control of 174.3±116.5,
P<0.0001). An in vitro model was developed to represent the
exposure of astrocytes to blood following an increase in BBB
permeability. Exposure of astrocytes to blood increases the number of
cells and their spread on the shunt.