Child's Nervous System

, Volume 30, Issue 2, pp 205–214 | Cite as

The choroid plexus: a comprehensive review of its history, anatomy, function, histology, embryology, and surgical considerations

  • Martin M. Mortazavi
  • Christoph J. Griessenauer
  • Nimer Adeeb
  • Aman Deep
  • Reza Bavarsad Shahripour
  • Marios Loukas
  • Richard Isaiah Tubbs
  • R. Shane Tubbs
Review Paper



The role of the choroid plexus in cerebrospinal fluid production has been identified for more than a century. Over the years, more intensive studies of this structure has lead to a better understanding of the functions, including brain immunity, protection, absorption, and many others. Here, we review the macro- and microanatomical structure of the choroid plexus in addition to its function and embryology.


The literature was searched for articles and textbooks for data related to the history, anatomy, physiology, histology, embryology, potential functions, and surgical implications of the choroid plexus. All were gathered and summarized comprehensively.


We summarize the literature regarding the choroid plexus and its surgical implications.


Choroid plexus Anatomy Neurosurgery Hydrocephalus 


  1. 1.
    Barshes N, Demopoulos A, Engelhard HH (2005) Anatomy and physiology of the leptomeninges and CSF space. Cancer Treat Res 125:1–16PubMedCrossRefGoogle Scholar
  2. 2.
    Rhoton AL Jr (2002) The lateral and third ventricles. Neurosurgery 51:S207–S271PubMedGoogle Scholar
  3. 3.
    Vesalius A (1543) De humani corporis fabrica libri septem. Oporinus, BaselGoogle Scholar
  4. 4.
    Willis T (1664) Cerebri anatome. LondonGoogle Scholar
  5. 5.
    Ridley H (1695) The anatomy of the brain. LondonGoogle Scholar
  6. 6.
    Dohrmann GJ (1970) The choroid plexus: a historical review. Brain Res 18:197–218PubMedCrossRefGoogle Scholar
  7. 7.
    Nagata S, Rhoton AL Jr, Barry M (1988) Microsurgical anatomy of the choroidal fissure. Surg Neurol 30:3–59PubMedCrossRefGoogle Scholar
  8. 8.
    Sharifi M, Ciolkowski M, Krajewski P, Ciszek B (2005) The choroid plexus of the fourth ventricle and its arteries. Folia Morphol (Warsz) 64:194–198Google Scholar
  9. 9.
    Jean WC, Abdel Aziz KM, Keller JT, van Loveren HR (2003) Subtonsillar approach to the foramen of Luschka: an anatomic and clinical study. Neurosurgery 52:860–866, discussion 866PubMedCrossRefGoogle Scholar
  10. 10.
    von Luschka H (1855) Die Adergeflechte des menschlichen Gehirnes: eine Monographie. Reimer, BerlinGoogle Scholar
  11. 11.
    Galeotti G (1897) Studio morfologico e citalogico della volta del diencefalo in alcuni vertebrati. Riv di patol nerv 2:480–517Google Scholar
  12. 12.
    Findlay JW (1899) The choroid plexus of the lateral ventricles of the brain: their histology, normal and pathologic. Brain 22:161–202CrossRefGoogle Scholar
  13. 13.
    Studnicka FK (1900) Untersuchungen über den Bau des Ependyms der nervösen Centralorgane. Anat Hefte 15:303–430Google Scholar
  14. 14.
    Hassin GB, Oldberg E, Tinsley M (1937) Changes in the brain in plexectomized dogs with comments on the cerebrospinal fluid. Arch Neurol Psychiatry 38:1224–1239CrossRefGoogle Scholar
  15. 15.
    Milhorat TH (1972) Hydrocephalus and the cerebrospinal fluid. Williams & Wilkins, BaltimoreGoogle Scholar
  16. 16.
    Milhorat TH, Hammock MK, Fenstermacher JD, Levin VA (1971) Cerebrospinal fluid production by the choroid plexus and brain. Science 173:330–332PubMedCrossRefGoogle Scholar
  17. 17.
    Milhorat TH (1975) The third circulation revisited. J Neurosurg 42:628–645PubMedCrossRefGoogle Scholar
  18. 18.
    Weed LH (1938) Meninges and cerebrospinal fluid. J Anat 72:181–215PubMedGoogle Scholar
  19. 19.
    Brown PD, Davies SL, Speake T, Millar ID (2004) Molecular mechanisms of cerebrospinal fluid production. Neuroscience 129:957–970PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    Thanos CG, Bintz B, Emerich DF (2010) Microencapsulated choroid plexus epithelial cell transplants for repair of the brain. Adv Exp Med Biol 670:80–91PubMedCrossRefGoogle Scholar
  21. 21.
    Kittisupamongkol W (2009) Cerebrospinal fluid production rate. Clin Experiment Ophthalmol 37:827, author reply 827–828PubMedGoogle Scholar
  22. 22.
    Takahashi H, Tanaka H, Fujita N, Murase K, Tomiyama N (2011) Variation in supratentorial cerebrospinal fluid production rate in one day: measurement by nontriggered phase-contrast magnetic resonance imaging. Jpn J Radiol 29:110–115PubMedCrossRefGoogle Scholar
  23. 23.
    Han ME, Kim HJ, Lee YS, Kim DH, Choi JT, Pan CS, Yoon S, Baek SY, Kim BS, Kim JB, Oh SO (2009) Regulation of cerebrospinal fluid production by caffeine consumption. BMC Neurosci 10:110PubMedCentralPubMedCrossRefGoogle Scholar
  24. 24.
    Artru AA (1983) Effects of halothane and fentanyl on the rate of CSF production in dogs. Anesth Analg 62:581–585PubMedCrossRefGoogle Scholar
  25. 25.
    Faraci FM, Mayhan WG, Heistad DD (1990) Vascular effects of acetazolamide on the choroid plexus. J Pharmacol Exp Ther 254:23–27PubMedGoogle Scholar
  26. 26.
    Egleton RD, Campos CC, Huber JD, Brown RC, Davis TP (2003) Differential effects of diabetes on rat choroid plexus ion transporter expression. Diabetes 52:1496–1501PubMedCrossRefGoogle Scholar
  27. 27.
    Ishikawa A, Kono K, Sakae R, Aiba T, Kawasaki H, Kurosaki Y (2010) Altered electrolyte handling of the choroid plexus in rats with glycerol-induced acute renal failure. Biopharm Drug Dispos 31:455–463PubMedCrossRefGoogle Scholar
  28. 28.
    Silverberg GD, Heit G, Huhn S, Jaffe RA, Chang SD, Bronte-Stewart H, Rubenstein E, Possin K, Saul TA (2001) The cerebrospinal fluid production rate is reduced in dementia of the Alzheimer's type. Neurology 57:1763–1766PubMedCrossRefGoogle Scholar
  29. 29.
    Snodgrass SR, Lorenzo AV (1972) Temperature and cerebrospinal fluid production rate. Am J Physiol 222:1524–1527PubMedGoogle Scholar
  30. 30.
    Askanazy M (1914) Zur Physiologie und Pathologie der Plexus Chorioidei. Zentr Allgem Pathol Anat 25:390–391Google Scholar
  31. 31.
    Becht FC (1920) Studies on the cerebrospinal fluid. Amer J Physiol 51:1–125Google Scholar
  32. 32.
    Hassin GB (1930) Hydrocephalus: studies of pathology and pathogenesis with remarks on cerebrospinal fluid. Arch Neurol and Psychiatr 24:1164–1186CrossRefGoogle Scholar
  33. 33.
    Hassin GB (1933) Histopathology of the peripheral and central nervous systems. William Wood & Company, BaltimoreGoogle Scholar
  34. 34.
    Hassin GB (1948) Cerebrospinal fluid, its origin, nature and function. J Neuropathol Exp Neurol 7:172–181PubMedCrossRefGoogle Scholar
  35. 35.
    van Deurs B (1976) Choroid plexus absorption of horseradish peroxidase from the cerebral ventricles. J Ultrastruct Res 55:400–416PubMedCrossRefGoogle Scholar
  36. 36.
    Redzic ZB, Segal MB (2004) The structure of the choroid plexus and the physiology of the choroid plexus epithelium. Adv Drug Deliv Rev 56:1695–1716PubMedCrossRefGoogle Scholar
  37. 37.
    Kolmer W (1921) Über eine eigenartige Beziehung von Wanderzellen zu den Choroideal-plexus des Gehirns der Wirbeltiere. Anat Anz 54:15–19Google Scholar
  38. 38.
    Ling EA, Kaur C, Lu J (1998) Origin, nature, and some functional considerations of intraventricular macrophages, with special reference to the epiplexus cells. Microsc Res Tech 41:43–56PubMedCrossRefGoogle Scholar
  39. 39.
    Dziegielewska KM, Ek J, Habgood MD, Saunders NR (2001) Development of the choroid plexus. Microsc Res Tech 52:5–20PubMedCrossRefGoogle Scholar
  40. 40.
    Tacconi L, Rossif M (1998) Choroid plexus papillomas: a clinicopathogenetic review. Neurosurg Q 8:191–205CrossRefGoogle Scholar
  41. 41.
    Guerard M (1833) Tumeur fongueuse dans le ventricle droit du eerveau chez une petite fille de trois ans. Bull Soc Anat 8:211–214Google Scholar
  42. 42.
    Perthes GC (1919) Gluckliche Entfernung eines tumors des plexus choriodeus an dem seiten ventrikel des. Cerebrums. Munch Med Wschr 66:677–678Google Scholar
  43. 43.
    Gaudio RM, Tacconi L, Rossi ML (1998) Pathology of choroid plexus papillomas: a review. Clin Neurol Neurosurg 100:165–186PubMedCrossRefGoogle Scholar
  44. 44.
    Lee SH, Park BJ, Kim EJ, Lim YJ (2009) Atypical choroid plexus papilloma in an adult. J Korean Neurosurg Soc 46:74–76PubMedCentralPubMedCrossRefGoogle Scholar
  45. 45.
    Mehta VA, Bettegowda C, Singer HS, Ahn ES (2010) Medullary cistern choroid plexus papilloma. Childs Nerv Syst ChNS off J Int Soc Pediatr Neurosurg 26:1825–1829CrossRefGoogle Scholar
  46. 46.
    Peyre M, Bah A, Kalamarides M (2012) Multifocal choroid plexus papillomas: case report. Acta neurochir 154:295–299PubMedCrossRefGoogle Scholar
  47. 47.
    Carter LP, Beggs J, Waggener JD (1972) Ultrastructure of three choroid plexus papillomas. Cancer 30:1130–1136PubMedCrossRefGoogle Scholar
  48. 48.
    Jeibmann A, Wrede B, Peters O, Wolff JE, Paulus W, Hasselblatt M (2007) Malignant progression in choroid plexus papillomas. J Neurosurg 107:199–202PubMedGoogle Scholar
  49. 49.
    Shintaku M, Nitta T, Matsubayashi K, Okamoto S (2008) Ossifying choroid plexus papilloma recurring with features of atypical papilloma. Neuropathol off J Jpn Soc Neuropathol 28:160–164CrossRefGoogle Scholar
  50. 50.
    Agarwal A, Chopra S, Sehgal AD (2004) Choroid plexus papilloma associated with developmental delay. Indian J Pediatr 71:763–766PubMedCrossRefGoogle Scholar
  51. 51.
    Kennedy S, Hanieh A, Clark B, Byard RW (1995) Choroid plexus papillomas in childhood. J Clin Neurosci Off J Neurosurg Soc Australas 2:350–353Google Scholar
  52. 52.
    Lozier AP, Arbaje YM, Scheithauer BW (2009) Supratentorial, extraventricular choroid plexus carcinoma in an adult: case report. Neurosurgery 65:E816–E817PubMedCrossRefGoogle Scholar
  53. 53.
    Packer RJ, Perilongo G, Johnson D, Sutton LN, Vezina G, Zimmerman RA, Ryan J, Reaman G, Schut L (1992) Choroid plexus carcinoma of childhood. Cancer 69:580–585PubMedCrossRefGoogle Scholar
  54. 54.
    Kang HS, Wang KC, Kim YM, Kim IO, Kim SK, Chi JG, Cho BK (1997) Choroid plexus carcinoma in an infant. J Korean Med Sci 12:162–167PubMedCentralPubMedGoogle Scholar
  55. 55.
    Kishore S, Negi G, Meena H, Anuradha K, Pathak PV, Bansal K (2012) Choroid plexus carcinoma in an adult. J Neurosci Rural Pract 3:71–73PubMedCentralPubMedCrossRefGoogle Scholar
  56. 56.
    Bekiesinska-Figatowska M, Madzik J, Biejat A, Maldyk J, Duczkowska A (2009) Choroid plexus carcinoma of the spinal canal without cranial lesion. Eur J Radiol Extra 72:e107–e109CrossRefGoogle Scholar
  57. 57.
    Tena-Suck ML, Gomez-Amador JL, Ortiz-Plata A, Salina-Lara C, Rembao-Bojorquez D, Vega-Orozco R (2007) Rhabdoid choroid plexus carcinoma: a rare histological type. Arq Neuro Psiquiatr 65:705–709CrossRefGoogle Scholar
  58. 58.
    Tripathy K, Misra A, Misra D, Pujari S, Nayak M, Rath J (2011) Melanotic choroid plexus carcinoma of the posterior fossa. J Clin Neurol 7:105–106PubMedCentralPubMedCrossRefGoogle Scholar
  59. 59.
    Dandy WE (1918) Extirpation of the choroid plexus of the lateral ventricles in communicating hydrocephalus. Ann Surg 68:569–579PubMedCrossRefGoogle Scholar
  60. 60.
    Dandy WE (1922) An operative procedure for hydrocephalus. Bull Johns Hopkins Hosp 33:189–190Google Scholar
  61. 61.
    Dandy WE (1938) The operative treatment of communicating hydrocephalus. Ann Surg 108:194–202PubMedCrossRefGoogle Scholar
  62. 62.
    Putnam TJ (1934) Treatment of hydrocephalus by endoscopic coagulation of the choroid plexus. Description of a new instrument and preliminary report of results. Engl J Med 210:1373–1376CrossRefGoogle Scholar
  63. 63.
    Scarff JE (1936) Endoscopic treatment of hydrocephalus; description of ventriculoscope and preliminary report of cases. Arch Neurol and Psychiatr 35:853–861CrossRefGoogle Scholar
  64. 64.
    Scarff JE (1952) Nonobstructive hydrocephalus; treatment by endoscopic cauterization of the choroid plexus; long term results. J Neurosurg 9:164–176PubMedCrossRefGoogle Scholar
  65. 65.
    Feld M (1957) La coagulation des plexus choroïdes par ventriculoscopie directe dans l'hydrocéphalie nonobstructive du nourrison. Neurochirurgie 3:70–79PubMedGoogle Scholar
  66. 66.
    Scarff JE (1970) The treatment of nonobstructive (communicating) hydrocephalus by endoscopic cauterization of the choroid plexuses. Journal of neurosurgery 33:1–18PubMedCrossRefGoogle Scholar
  67. 67.
    Stookey B, Scarff J (1936) Occlusion of the aqueduct of Sylvius by neoplastic and non-neoplastic processes, with a rational surgical treatment for relief of the resultant obstructive hydrocephalus. Bull Neur Inst New York 5:348Google Scholar
  68. 68.
    Scarff JE (1966) Evaluation of treatment of hydrocephalus. Results of third ventriculostomy and endoscopic cauterization of choroid plexuses compared with mechanical shunts. Archives of neurology 14:382–391PubMedCrossRefGoogle Scholar
  69. 69.
    Warf BC (2005) Comparison of endoscopic third ventriculostomy alone and combined with choroid plexus cauterization in infants younger than 1 year of age: a prospective study in 550 African children. Journal of neurosurgery 103:475–481PubMedGoogle Scholar
  70. 70.
    Warf BC, Tracy S, Mugamba J (2012) Long-term outcome for endoscopic third ventriculostomy alone or in combination with choroid plexus cauterization for congenital aqueductal stenosis in African infants. Journal of neurosurgery Pediatrics 10:108–111PubMedCrossRefGoogle Scholar
  71. 71.
    Malheiros JA, Trivelato FP, Oliveira MM, Gusmao S, Cochrane DD, Steinbok P (2010) Endoscopic choroid plexus cauterization versus ventriculoperitoneal shunt for hydranencephaly and near hydranencephaly: a prospective study. Neurosurgery 66:459–464, discussion 464PubMedCrossRefGoogle Scholar
  72. 72.
    Bruno A, Graff-Radford NR, Biller J, Adams HP Jr (1989) Anterior choroidal artery territory infarction: a small vessel disease. Stroke 20:616–619PubMedCrossRefGoogle Scholar
  73. 73.
    Leys D, Mounier-Vehier F, Lavenu I, Rondepierre P, Pruvo JP (1994) Anterior choroidal artery territory infarcts. Study of presumed mechanisms. Stroke 25:837–842PubMedCrossRefGoogle Scholar
  74. 74.
    Wiesmann M, Yousry I, Seelos KC, Yousry TA (2001) Identification and anatomic description of the anterior choroidal artery by use of 3D-TOF source and 3D-CISS MR imaging. AJNR Am J Neuroradiol 22:305–310PubMedGoogle Scholar
  75. 75.
    Saeki N, Shimazaki K, Yamaura A (1999) Isolated infarction in the territory of lateral posterior choroidal arteries. J Neurol Neurosurg Psychiatry 67:413–415PubMedCrossRefGoogle Scholar
  76. 76.
    Ohta T, Ozawa H, Yamauchi T, Kubokura T (2003) Ruptured aneurysm of the medial posterior choroidal artery first demonstrated by the microcatheter technique—case report. Neurol med chir 43:601–604CrossRefGoogle Scholar
  77. 77.
    Atkinson WJ (1949) The anterior inferior cerebellar artery; its variations, pontine distribution, and significance in the surgery of cerebello-pontine angle tumours. J Neurol Neurosurg Psychiatry 12:137–151PubMedCrossRefGoogle Scholar
  78. 78.
    Snell RS (2010) Clinical neuroanatomy . Wolters Kluwer, Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Martin M. Mortazavi
    • 1
  • Christoph J. Griessenauer
    • 1
  • Nimer Adeeb
    • 2
  • Aman Deep
    • 2
  • Reza Bavarsad Shahripour
    • 3
  • Marios Loukas
    • 4
  • Richard Isaiah Tubbs
    • 2
  • R. Shane Tubbs
    • 2
    • 4
    • 5
  1. 1.Department of Neurological SurgeryUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Department of Neurological SurgeryThe Children’s Hospital of AlabamaBirminghamUSA
  3. 3.Comprehensive Stroke CenterUniversity of Alabama HospitalBirminghamUSA
  4. 4.Department of Anatomical SciencesSt. George’s UniversityTrue BlueGrenada
  5. 5.Centre of Anatomy and Human IdentificationDundee UniversityDundeeUK

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