Abstract
A comprehensive understanding of the cerebrospinal fluid (CSF) space anatomy is essential in clinical neuroradiology for the accurate localization and interpretation of a range of intracranial pathologies. The embryology of the ventricular system and cisterns is discussed, before each component of these structures is further described in more detail, including the spinal CSF anatomy. The common anatomical variants are also described. A clinical case is also included. Our understanding of the physiology of CSF flow is often still taught using the classical hypothesis. Modern imaging techniques as well as new scientific evidence are, however, introducing new concepts of CSF production, resorption, and flow. These new speculations on CSF flow are discussed. Modern imaging techniques support the current hypothesis of CSF flowing in a bidirectional manner driven by the expansion of intracranial arteries during systole. This forces CSF downward into the relatively elastic spinal canal in systole with upward return flow of CSF into the intracranial compartment in diastole. Radiology, therefore, plays an important role in the understanding of the anatomy of the CSF spaces and ventricular system, as well as the hydrodynamics of CSF flow. These principles are important to the understanding of pathological processes affecting the ventricles and CSF spaces as described in the subsequent sections of this chapter.
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Abbreviations
- CSF:
-
Cerebrospinal fluid
- MRI:
-
Magnetic resonance imaging
- PC-MRI:
-
Phase contrast magnetic resonance imaging
- SAS:
-
Subarachnoid space
References
Bateman GA. Vascular compliance in normal pressure hydrocephalus. AJNR Am J Neuroradiol. 2000;21(9):1574–85. PubMed PMID: 11039334.
Bateman GA. Pulse-wave encephalopathy: a comparative study of the hydrodynamics of leukoaraiosis and normal-pressure hydrocephalus. Neuroradiology. 2002;44(9):740–8. PubMed PMID: 12221445.
Dandy WE, Blackfan KD. Internal hydrocephalus. An experimental, clinical and pathological study. Am J Dis Child. 1914;8:406–81.
Dogan SN, Kizilkilic O, Kocak B, Isler C, Islak C, Kocer N. Intrathecal gadolinium-enhanced MR cisternography in patients with otorhinorrhea: 10-year experience of a tertiary referral centre. Neuroradiology. 2018;60:471–7.
Grainger A, Rowe J, Romanowski CAJ, Hunt K, Walton L, Kemeny A. CT cisternography for localisation of the trigeminal nerve prior to Gamma Knife radiosurgery (Revisiting an old technique). Amsterdam: European Gamma Knife Society; 2012.
Greitz D. Radiological assessment of hydrocephalus: new theories and implications for therapy. Neurosurg Rev. 2004;27(3):145–65; discussion 66–7. PubMed PMID: 15164255.
Greitz D, Wirestam R, Franck A, Nordell B, Thomsen C, Stahlberg F. Pulsatile brain movement and associated hydrodynamics studied by magnetic resonance phase imaging. The Monro-Kellie doctrine revisited. Neuroradiology. 1992;34(5):370–80. PubMed PMID: 1407513.
Greitz D, Greitz T, Hindmarsh T. A new view on the CSF-circulation with the potential for pharmacological treatment of childhood hydrocephalus. Acta Paediatr. 1997;86(2):125–32. PubMed PMID: 9055878.
Griffiths PD, Batty R, Reeves MJ, et al. Imaging the corpus callosum, septum pellucidum and fornix in children: normal anatomy and variations of normality. Neuroradiology. 2009;51:337.
Kelly EJ, Yamada S. Cerebrospinal fluid flow studies and recent advancements. Semin Ultrasound CT MRI. 2016;37:92–9. https://doi.org/10.1053/j.sult.2016.01.002.
Kim J, Thacker NA, Bromiley PA, Jackson A. Prediction of the jugular venous waveform using a model of CSF dynamics. AJNR Am J Neuroradiol. 2007;28(5):983–9. PubMed PMID: 17494684. Epub 2007/05/15. eng.
Kinotshita T, Moritani T, Hiwatashi A, et al. Clinically silent choroid plexus cyst: evaluation by diffusion-weighted MRI. Neuroradiology. 2005;47(4):251–5.
Stolz E, Kaps M, Kern A, Babacan SS, Dorndorf W. Transcranial color-coded duplex sonography of intracranial veins and sinuses in adults. Reference data from 130 volunteers. Stroke. 1999;30(5):1070–5. PubMed PMID: 10229746. Epub 1999/05/07. eng.
Further Reading
Gray’s Anatomy: the anatomical basis of clinical practice. 41st ed. Susan Strandring. Elsevier; 2015. Chapter 18. Edinburgh.
Naidich TP, Castillo M, Cha S, Smirniopoulos JG. Imaging of the brain. Saunders; Philadelphia. 2013.
Oreškovića D, Radoš M, Klarica M. New concepts of cerebrospinal fluid physiology and development of hydrocephalus. Pediatr Neurosurg. 2017;52:417–25.
Osborn A. Osborn’s brain: imaging, pathology, and anatomy. Philadelphia: Lippincott, Williams & Wilkins/Amirsys Publishing. 2017.
ten Donkelaar HJ, van der Vliet T. Overview of the development of the human brain and spinal cord. In: ten Donkelaar HJ, Lammens M, Hori S, editors. Clinical neuroembryology. Berlin/Heidelberg: Springer; 2006. p. 1–46.
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Igra, M.S., Romanowski, C.A.J., Stivaros, S.M. (2019). Imaging of CSF Spaces, Physiology, and Hydrodynamics. In: Barkhof, F., Jager, R., Thurnher, M., Rovira Cañellas, A. (eds) Clinical Neuroradiology. Springer, Cham. https://doi.org/10.1007/978-3-319-61423-6_5-2
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