Pediatric hydrocephalus is one of the most commonly encountered pathology in pediatric neurosurgery with an overall incidence of three in 1,000 children under 2 years of age. Cerebrospinal fluid (CSF) abnormally accumulates in different regions of the brain and can raise intracranial pressure resulting in severe brain damage or mortality if left untreated. Various etiologies of hydrocephalus exist, including intracranial hemorrhage, brain tumors, congenital brain malformations, neural tube defects, as well as others. Unfortunately, for a significant population, this condition has an unknown etiology.

Several surgical treatments are available for pediatric hydrocephalus. These include resection of lesions that physically obstruct CSF flow, or CSF diversionary surgery to control CSF accumulation and ventricular size. These options have greatly reduced the morbidity and mortality associated with this condition. However, the long-term management of optimal shunt function is a challenge especially in young children and may require multiple brain surgeries during the patient’s life time.

Research in the Mangano Lab is directed at understanding pathogenesis of pediatric hydrocephalus, that will lead us to develop new surgical and medical treatment options and to improve patient outcomes and quality of life. To establish the goals, we study essential brain anatomy, neural cell types, and genes involved in pediatric hydrocephalus utilizing advanced MR imaging methods (diffusion tensor imaging), mouse genetic models, and several surgical techniques.

Two main aspects of research are currently ongoing in the lab. Each project includes active collaborations with multidisciplinary researchers across divisions at Cincinnati Children’s, including the Division of Radiology, Division of Developmental Biology, and Division of Human Genetics.

Our current projects include:

  1. Diffusion tensor imaging and neural stem cell behavior in infantile rat model of obstructive hydrocephalus.
  2. Molecular mechanism of non-obstructive pediatric hydrocephalus in mouse genetic mutants.