Skip to main content

CSF Physiology and Intracranial Pressure

  • Chapter
  • First Online:
Skull Base Reconstruction

Abstract

This is a review of the physiology of cerebral spinal fluid (CSF), including its purpose and content and the details of CSF production, circulation, and resorption. An introduction to the pathology of the skull base and how it impacts CSF physiology is presented. Also explored are the specifics of intracranial pressure (ICP) and the relationship to skull base pathology. Lastly is a review of approaches to ICP control via modulation of the intracranial constituents of the brain, blood, and CSF.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Rink C, Khanna S. Significance of brain tissue oxygenation and the arachidonic acid cascade in stroke. Antioxid Redox Signal. 2011;14(10):1889–903. https://doi.org/10.1089/ars.2010.3474.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Hofman FM, Chen TC. Chapter 3—Choroid plexus: structure and function, the choroid plexus and cerebrospinal fluid. Cambridge: Academic Press; 2016. p. 29–40, ISBN 9780128017401

    Book  Google Scholar 

  3. Sakka L, Coll G, Chazal J. Anatomy and physiology of cerebrospinal fluid. Eur Ann Otorhinolaryngol Head Neck Dis. 2011;128(6):309–16. https://doi.org/10.1016/j.anorl.2011.03.002. Epub 2011 Nov 18

    Article  CAS  PubMed  Google Scholar 

  4. Tumani H, Huss A, Bachhuber F. The cerebrospinal fluid and barriers—anatomic and physiologic considerations. Handb Clin Neurol. 2017;146:21–32. https://doi.org/10.1016/B978-0-12-804279-3.00002-2.

    Article  PubMed  Google Scholar 

  5. Oldendorf WH, Hyman S, Braun L, Oldendorf SZ. Blood-brain barrier: penetration of morphine, codeine, heroin, and methadone after carotid injection. Science. 1972;178(4064):984–6. https://doi.org/10.1126/science.178.4064.984.

    Article  CAS  PubMed  Google Scholar 

  6. Nau R, Sörgel F, Prange HW. Lipophilicity at pH 7.4 and molecular size govern the entry of the free serum fraction of drugs into the cerebrospinal fluid in humans with uninflamed meninges. J Neurol Sci. 1994;122(1):61–5. https://doi.org/10.1016/0022-510x(94)90052-3.

    Article  CAS  PubMed  Google Scholar 

  7. Harary M, Dolmans RGF, Gormley WB. Intracranial pressure monitoring-review and avenues for development. Sensors (Basel). 2018;18(2):465. https://doi.org/10.3390/s18020465.

    Article  PubMed  Google Scholar 

  8. Xu Q, Yu SB, Zheng N, Yuan XY, Chi YY, Liu C, Wang XM, Lin XT, Sui HJ. Head movement, an important contributor to human cerebrospinal fluid circulation. Sci Rep. 2016;19(6):31787. https://doi.org/10.1038/srep31787.

    Article  CAS  Google Scholar 

  9. Miller AD, Leslie RA. The area postrema and vomiting. Front Neuroendocrinol. 1994;15(4):301–20. https://doi.org/10.1006/frne.1994.1012.

    Article  CAS  PubMed  Google Scholar 

  10. Sabancı PA, Batay F, Civelek E, Al Mefty O, Husain M, Abdulrauf SI, Karasu A. Meckel’s cave. World Neurosurg. 2011;76(3–4):335–41; discussion 266-7. https://doi.org/10.1016/j.wneu.2011.03.037.

    Article  PubMed  Google Scholar 

  11. Ahn JH, Cho H, Kim JH, Kim SH, Ham JS, Park I, Suh SH, Hong SP, Song JH, Hong YK, Jeong Y, Park SH, Koh GY. Meningeal lymphatic vessels at the skull base drain cerebrospinal fluid. Nature. 2019;572(7767):62–6. https://doi.org/10.1038/s41586-019-1419-5. Epub 2019 Jul 24

    Article  CAS  PubMed  Google Scholar 

  12. Brierly JB, Field EJ, Yoffey JM. Passage of indian ink particles from the cranial subarachnoid space. J Anat. 1949;83(Pt 1):77.

    Google Scholar 

  13. Silver I, Li B, Szalai J, Johnston M. Relationship between intracranial pressure and cervical lymphatic pressure and flow rates in sheep. Am J Phys. 1999;277(6):R1712–7. https://doi.org/10.1152/ajpregu.1999.277.6.R1712.

    Article  CAS  Google Scholar 

  14. Mollanji R, Bozanovic-Sosic R, Zakharov A, Makarian L, Johnston MG. Blocking cerebrospinal fluid absorption through the cribriform plate increases resting intracranial pressure. Am J Physiol Regul Integr Comp Physiol. 2002;282(6):R1593–9. https://doi.org/10.1152/ajpregu.00695.2001.

    Article  CAS  PubMed  Google Scholar 

  15. Földi M, Csillik B, Zoltán OT. Lymphatic drainage of the brain. Experientia. 1968;24(12):1283–7. https://doi.org/10.1007/BF02146675.

    Article  PubMed  Google Scholar 

  16. Bothwell SW, Janigro D, Patabendige A. Cerebrospinal fluid dynamics and intracranial pressure elevation in neurological diseases. Fluids Barriers CNS. 2019;16(1):9. https://doi.org/10.1186/s12987-019-0129-6.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Xie L, Kang H, Xu Q, Chen MJ, Liao Y, Thiyagarajan M, O'Donnell J, Christensen DJ, Nicholson C, Iliff JJ, Takano T, Deane R, Nedergaard M. Sleep drives metabolite clearance from the adult brain. Science. 2013;342(6156):373–7. https://doi.org/10.1126/science.1241224.

    Article  CAS  PubMed  Google Scholar 

  18. Iliff JJ, Wang M, Liao Y, Plogg BA, Peng W, Gundersen GA, Benveniste H, Vates GE, Deane R, Goldman SA, Nagelhus EA, Nedergaard M. A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid β. Sci Transl Med. 2012;4(147):147ra111. https://doi.org/10.1126/scitranslmed.3003748.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Schwake M, Schipmann S, Müther M, Stögbauer L, Hanning U, Sporns PB, Ewelt C, Dziewas R, Minnerup J, Holling M, Stummer W. Second-look strokectomy of cerebral infarction areas in patients with severe herniation. J Neurosurg. 2019;132(1):1–9. https://doi.org/10.3171/2018.8.JNS18692.

    Article  PubMed  Google Scholar 

  20. Wu EM, El Ahmadieh TY, Kafka B, Caruso J, Aoun SG, Plitt AR, Neeley O, Olson DM, Ruchinskas RA, Cullum M, Batjer H, White JA. Ventriculoperitoneal shunt outcomes of Normal pressure hydrocephalus: a case series of 116 patients. Cureus. 2019;11(3):e4170. https://doi.org/10.7759/cureus.4170.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Warf BC. 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. J Neurosurg. 2005;103(6 Suppl):475–81. https://doi.org/10.3171/ped.2005.103.6.0475.

    Article  PubMed  Google Scholar 

  22. Golanov EV, Bovshik EI, Wong KK, Pautler RG, Foster CH, Federley RG, Zhang JY, Mancuso J, Wong ST, Britz GW. Subarachnoid hemorrhage - induced block of cerebrospinal fluid flow: role of brain coagulation factor III (tissue factor). J Cereb Blood Flow Metab. 2018;38(5):793–808. https://doi.org/10.1177/0271678X17701157. Epub 2017 Mar 28

    Article  CAS  PubMed  Google Scholar 

  23. Germanwala AV, Huang J, Tamargo RJ. Hydrocephalus after aneurysmal subarachnoid hemorrhage. Neurosurg Clin N Am. 2010;21(2):263–70. https://doi.org/10.1016/j.nec.2009.10.013.

    Article  PubMed  Google Scholar 

  24. Custodio G, Taques GR, Figueiredo BC, Gugelmin ES, Oliveira Figueiredo MM, Watanabe F, Pontarolo R, Lalli E, Torres LF. Increased incidence of choroid plexus carcinoma due to the germline TP53 R337H mutation in southern Brazil. PLoS One. 2011;6(3):e18015. https://doi.org/10.1371/journal.pone.0018015.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Grygotis LA, Chew FS. Choroid plexus carcinoma of the lateral ventricle. AJR Am J Roentgenol. 1997;169(5):1400. https://doi.org/10.2214/ajr.169.5.9353468.

    Article  CAS  PubMed  Google Scholar 

  26. Kornienko VN. Diagnostic Neuroradiology. In: Igor Nikolaevich Pronin. New York: Springer. ISBN:3540756523.

    Google Scholar 

  27. Kerleroux B, Cottier JP, Janot K, Listrat A, Sirinelli D, Morel B. Posterior fossa tumors in children: radiological tips & tricks in the age of genomic tumor classification and advance MR technology. J Neuroradiol. 2020;47(1):46–53. https://doi.org/10.1016/j.neurad.2019.08.002. Epub 2019 Sep 18

    Article  PubMed  Google Scholar 

  28. West KW, Turner MK, Vane DW, Boaz J, Kalsbeck J, Grosfeld JL. Ventricular gallbladder shunts: an alternative procedure in hydrocephalus. J Pediatr Surg. 1987;22(7):609–12. https://doi.org/10.1016/s0022-3468(87)80110-0.

    Article  CAS  PubMed  Google Scholar 

  29. Morosanu CO, Filip GA, Nicolae L, Florian IS. From the heart to the bladder-particularities of ventricular shunt topography and the current status of cerebrospinal fluid diversion sites. Neurosurg Rev. 2020;43(3):847–60. https://doi.org/10.1007/s10143-018-1033-2. Epub 2018 Oct 18

    Article  PubMed  Google Scholar 

  30. Tao C, Fan C, Hu X, Ma J, Ma L, Li H, Liu Y, Sun H, He M, You C. The effect of fenestration of the lamina terminalis on the incidence of shunt-dependent hydrocephalus after aneurysmal subarachnoid hemorrhage (FISH): study protocol for a randomized controlled trial. Medicine (Baltimore). 2016;95(52):e5727. https://doi.org/10.1097/MD.0000000000005727.

    Article  PubMed  Google Scholar 

  31. Mao J, Zhu Q, Ma Y, Lan Q, Cheng Y, Liu G. Fenestration of lamina terminalis during anterior circulation aneurysm clipping on occurrence of shunt-dependent hydrocephalus after aneurysmal subarachnoid hemorrhage: meta-analysis. World Neurosurg. 2019;129:e1–5. https://doi.org/10.1016/j.wneu.2019.01.270. Epub 2019 Feb 16

    Article  PubMed  Google Scholar 

  32. Illes S. More than a drainage fluid: the role of CSF in signaling in the brain and other effects on brain tissue. Handb Clin Neurol. 2017;146:33–46. https://doi.org/10.1016/B978-0-12-804279-3.00003-4.

    Article  PubMed  Google Scholar 

  33. Kato K, Ujiie H, Higa T, Hayashi M, Kubo O, Okada Y, Hori T. Clinical presentation of intracranial epidermoids: a surgical series of 20 initial and four recurred cases. Asian. J Neurosurg. 2010;5(1):32–40.

    Google Scholar 

  34. Kralick F, Oh J, Medina T, Noh HM. Micro-fabricated shunt to mimic arachnoid granulations for the treatment of communicating hydrocephalus. Acta Neurochir Suppl. 2012;114:239–42. https://doi.org/10.1007/978-3-7091-0956-4_47.

    Article  PubMed  Google Scholar 

  35. Heilman CB, Basil GW, Beneduce BM, Malek AM. Anatomical characterization of the inferior petrosal sinus and adjacent cerebellopontine angle cistern for development of an endovascular transdural cerebrospinal fluid shunt. J Neurointerv Surg. 2019;11(6):598–602. https://doi.org/10.1136/neurintsurg-2018-014445. Epub 2019 Jan 9

    Article  PubMed  Google Scholar 

  36. Malek A, Heilman C. E-020 design of an endovascular transdural cerebrospinal fluid shunt implant to MIMIC arachnoid granulation function. J NeuroInterventional Surgery. 2018;10:A57.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Frank P. K. Hsu .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Davies, J., Paff, M., Chen, J.W., Golshani, K., Hsu, F.P.K. (2023). CSF Physiology and Intracranial Pressure. In: Kuan, E.C., Tajudeen, B.A., Djalilian, H.R., Lin, H.W. (eds) Skull Base Reconstruction . Springer, Cham. https://doi.org/10.1007/978-3-031-27937-9_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-27937-9_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-27936-2

  • Online ISBN: 978-3-031-27937-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics