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Physiology of CSF

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CSF Rhinorrhea

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Abstract

Cerebrospinal fluid (CSF) is a clear, colorless ultrafiltrate of plasma located within the ventricles of the brain and the subarachnoid spaces of the cranium and spine. In adults, the mean CSF volume is 150 mL distributed among the ventricles (25 mL) and subarachnoid spaces (125 mL). When compared to plasma, CSF has a higher concentration of sodium, chloride, and magnesium and a lower concentration of potassium and calcium. CSF performs many dynamic functions including protection to the brain and spinal cord, providing nourishment and removal of waste products. CSF is predominantly secreted by the choroid plexuses, which are located within the ventricles of the brain. CSF travels from the lateral ventricles through the interventricular foramina to the third ventricle, through the cerebral aqueduct to the fourth ventricle, and then through the median aperture into the subarachnoid space at the base of the brain. CSF, mainly, leaves the subarachnoid space through arachnoid villi along the superior sagittal venous sinus, intracranial venous sinuses, and around the roots of spinal nerves. Any change in the volume, pressure, and/or composition of the CSF leads to neural malfunction. Despite this historically gold standard classical theory of CSF hydrodynamics, recent studies evolved to postulate that the CSF production and absorption (CSF exchange) are constant and present everywhere in the CSF system.

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References

  1. Hajdu SI. A note from history: discovery of the cerebrospinal fluid. Ann Clin Lab Sci. 2003;33:334–6.

    PubMed  Google Scholar 

  2. Cushing H. Studies on the cerebro-spinal fluid: I. Introduction. J Med Res. 1914;31:1–9.

    PubMed  PubMed Central  CAS  Google Scholar 

  3. Dandy WE. Experimental hydrocephalus. Ann Surg. 1919;70:129–42.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Johanson CE, Duncan JA 3rd, Klinge PM, Brinker T, Stopa EG, Silverberg GD, et al. Multiplicity of cerebrospinal fluid functions: new challenges in health and disease. Cerebrospinal Fluid Res. 2008;5:10.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Tumani H, Huss A, Bachhuber F. The cerebrospinal fluid and barriers - anatomic and physiologic considerations. Handb Clin Neurol. 2017;146:21–32.

    Article  PubMed  Google Scholar 

  6. Spector R, Robert Snodgrass S, Johanson CE. A balanced view of the cerebrospinal fluid composition and functions: focus on adult humans. Exp Neurol. 2015;273:57–68.

    Article  PubMed  CAS  Google Scholar 

  7. Sakka L, Coll G, Chazal J. Anatomy and physiology of cerebrospinal fluid. Eur Ann Otorhinolaryngol Head Neck Dis. 2011;128(6):309–16.

    Article  PubMed  CAS  Google Scholar 

  8. Guyton AC, Hall JE. Textbook of medical physiology. 11th ed. W.B. Saunders; 2005. p. 764–7.

    Google Scholar 

  9. Saladin K. Anatomy and physiology. 6th ed. McGraw Hill; 2012. p. 519–20.

    Google Scholar 

  10. Bulat M, Klarica M. Recent insights into a new hydrodynamics of the cerebrospinal fluid. Brain Res Rev. 2011;65:99–112.

    Article  PubMed  Google Scholar 

  11. Brown PD, Davies SL, Speake T, Millar ID. Molecular mechanisms of cerebrospinal fluid production. Neuroscience. 2004;129:957–70.

    Article  PubMed  CAS  Google Scholar 

  12. Felgenhauer K. Protein size and CSF composition. Klin Wochenschr. 1974;52(24):1158–64.

    Article  PubMed  CAS  Google Scholar 

  13. Merril CR, Goldman D, Sedman SA, Ebert MH. Ultrasensitive stain for proteins in polyacrylamide gels shows regional variation in cerebrospinal fluid proteins. Science. 1981;211(4489):1437–8.

    Article  PubMed  CAS  Google Scholar 

  14. Saunders NR, Habgood MD, Dziegielewska KM. Barrier mechanisms in the brain, I. adult brain. Clin Exp Pharmacol Physiol. 1999;26:11–9.

    Article  PubMed  CAS  Google Scholar 

  15. Jurado R, Walker HK. Cerebrospinal fluid. In: Clinical methods: the history, physical, and laboratory examinations. 3rd ed. Butterworths; 1990.

    Google Scholar 

  16. Damkier HH, Brown PD, Praetorius J. Epithelial pathways in choroid plexus electrolyte transport. Physiology (Bethesda). 2010;25(4):239–49.

    CAS  Google Scholar 

  17. Wright BLC, Lai JTF, Sinclair AJ. Cerebrospinal fluid and lumbar puncture: a practical review. J Neurol. 2012;259(8):1530–45.

    Article  PubMed  Google Scholar 

  18. Noback C, Strominger NL, Demarest RJ, Ruggiero DA. The human nervous system. Humana Press; 2005. p. 93.

    Google Scholar 

  19. Ropper AH, Brown RH. Adams and victor’s principles of neurology. 8th ed. McGraw-Hill Professional; 2005. p. 530.

    Google Scholar 

  20. Speake T, Whitwell C, Kajita H, Majid A, Brown PD. Mechanisms of CSF secretion by the choroid plexus. Microsc Res Tech. 2001;52(1):49–59.

    Article  PubMed  CAS  Google Scholar 

  21. Damkier HH, Brown PD, Praetorius J. Cerebrospinal fluid secretion by the choroid plexus. Physiol Rev. 2013;93(4):1847–92.

    Article  PubMed  CAS  Google Scholar 

  22. Roales-Buján R, Páez P, Guerra M, Rodríguez S, Vío K, Ho-Plagaro A, et al. Astrocytes acquire morphological and functional characteristics of ependymal cells following disruption of ependyma in hydrocephalus. Acta Neuropathol. 2012;124:531–46.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Orešković D, Radoš M, Klarica M. Role of choroid plexus in cerebrospinal fluid hydrodynamics. Neuroscience. 2017 Jun;23(354):69–87.

    Article  Google Scholar 

  24. Brinker T, Stopa E, Morrison J, Klinge P. A new look at cerebrospinal fluid circulation. Fluids Barriers CNS. 2014;11:10. and Spector R, Robert Snodgrass S, Johanson CE. A balanced view of the cerebrospinal fluid composition and functions: focus on adult humans. Exp Neurol. 2015;273:57–68.

    Google Scholar 

  25. le Gros Clark WE. On the pacchionian bodies. J Anat. 1920;55:40–8.

    PubMed  PubMed Central  Google Scholar 

  26. Mack J, Squier W, Eastman JT. Anatomy and development of the meninges: implications for subdural collections and CSF circulation. Pediatr Radiol. 2009;39:200–10.

    Article  PubMed  Google Scholar 

  27. Miyajima M, Arai H. Evaluation of the production and absorption of cerebrospinal fluid. Neurol Med Chir (Tokyo). 2015;55(8):647–56.

    Article  Google Scholar 

  28. Chikly B, Quaghebeur J. Reassessing cerebrospinal fluid (CSF) hydrodynamics: a literature review presenting a novel hypothesis for CSF physiology. J Bodyw Mov Ther. 2013;17(3):344–54.

    Article  PubMed  Google Scholar 

  29. Oresković D, Klarica M. The formation of cerebrospinal fluid: nearly a hundred years of interpretations and misinterpretations. Brain Res Rev. 2010;64:241–62.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Cairo University, Cairo, Egypt

    Reda Kamel & Hussam Elbosraty

  2. Department of Neurosurgery, Cairo University, Cairo, Egypt

    Mohamed Hafez

  3. Department of Otorhinolaryngology, Students Hospital, Cairo University, Cairo, Egypt

    Tarek Kandil

Authors
  1. Reda Kamel
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  2. Hussam Elbosraty
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  3. Mohamed Hafez
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  4. Tarek Kandil
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Corresponding author

Correspondence to Reda Kamel .

Editor information

Editors and Affiliations

  1. Department of Otorhinolaryngology, King Fahd Medical City, Riyadh, Saudi Arabia

    Abdulaziz A. AlQahtani

  2. Department of Otorhinolaryngology, University of Insubria, Varese, Varese, Italy

    Paolo Castelnuovo

  3. Department of Otolaryngology, Head and Neck Surgery, University of Miami, Miller School of Medicine, Miami, FL, USA

    Roy Casiano

  4. Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Ricardo L. Carrau

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Kamel, R., Elbosraty, H., Hafez, M., Kandil, T. (2022). Physiology of CSF. In: AlQahtani, A.A., Castelnuovo, P., Casiano, R., Carrau, R.L. (eds) CSF Rhinorrhea. Springer, Cham. https://doi.org/10.1007/978-3-030-94781-1_2

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  • DOI: https://doi.org/10.1007/978-3-030-94781-1_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-94780-4

  • Online ISBN: 978-3-030-94781-1

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