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The pathophysiology of posthemorrhagic hydrocephalus (PHH) development after GMH is complex and vaguely understood, although evidence suggests fibrosis and gliosis in the periventricular and subarachnoid spaces disrupts normal cerebrospinal fluid (CSF) dynamics. Theories explaining general hydrocephalus etiology have substantially evolved from the original bulk flow theory developed by Dr. Dandy over a century ago. Current clinical and experimental evidence supports a new hydrodynamic theory for hydrocephalus development involving redistribution of vascular pulsations and disruption of Starling forces in the brain microcirculation. In this review, we discuss CSF flow dynamics, history and development of theoretical hydrocephalus pathophysiology, and GMH epidemiology and etiology as it relates to PHH development. We highlight known mechanisms and propose new avenues that will further elucidate GMH pathophysiology, specifically related to hydrocephalus.<\/jats:p>","DOI":"10.1002\/jnr.24394","type":"journal-article","created":{"date-parts":[[2019,2,22]],"date-time":"2019-02-22T01:06:55Z","timestamp":1550797615000},"page":"105-120","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":79,"title":["Posthemorrhagic hydrocephalus development after germinal matrix hemorrhage: Established mechanisms and proposed pathways"],"prefix":"10.1002","volume":"98","author":[{"given":"Damon","family":"Klebe","sequence":"first","affiliation":[{"name":"Department of Physiology and Pharmacology Loma Linda University School of Medicine Loma Linda California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8988-3353","authenticated-orcid":false,"given":"Devin","family":"MBride","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology Loma Linda University School of Medicine Loma Linda California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul R.","family":"Krafft","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology Loma Linda University School of Medicine Loma Linda California"},{"name":"Department of Neurosurgery Loma Linda University School of Medicine Loma Linda California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5967-5999","authenticated-orcid":false,"given":"Jerry J.","family":"Flores","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology Loma Linda University School of Medicine Loma Linda California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2392-9280","authenticated-orcid":false,"given":"Jiping","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology Loma Linda University School of Medicine Loma Linda California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4319-4285","authenticated-orcid":false,"given":"John H.","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology Loma Linda University School of Medicine Loma Linda California"},{"name":"Department of Anesthesiology and Neurosurgery Loma Linda University School of Medicine Loma Linda California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-018-1812-4"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.679092"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2012.09.038"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3171\/2012.8.PEDS11386"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20142290"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3171\/2012.1.FOCUS11366"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1203\/PDR.0b013e3181c1b176"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2013.09.007"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1203\/01.PDR.0000130472.30874.FF"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm1558"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1962.19.5.0405"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/scrt512"},{"key":"e_1_2_9_14_1","first-page":"289","article-title":"Normal pressure hydrocephalus","volume":"22","author":"Black P.","year":"2008","journal-title":"Progress in Clinical Neurosciences"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jcbfm.9600306"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.4119"},{"issue":"4","key":"e_1_2_9_17_1","first-page":"F329","article-title":"Drainage of cerebral interstitial fluid into deep cervical lymph of the rabbit","volume":"240","author":"Bradbury M. 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