A Unified Physical Theory for CSF Circulation, Cooling and Cleaning of the Brain, Sleep, and Head Injuries in Degenerative Cognitive Disorders
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Cerebrospinal fluid (CSF) from the basal cisterns transits into the brain through spaces that surround the vascular system of the brain; the so-called paravascular spaces (Virchow Robin Spaces), or paravascular pathway, which surround the arteries, veins, and capillaries. The passage of CSF through these paravascular spaces is driven by the cardiovascular and respiratory systems, and is more active at night during sleep. Their cumulative function is presumed to include the clearance (or “cleaning”) of metabolic wastes, which likely contributes to counteracting metabolic heat, via the “cooling” of the brain. This paravascular CSF transport system might be implicated in CSF shift edema that occurs in head injuries; hence, it may be the rationale behind why opening the cisterns to atmospheric pressure through cisternostomy, quickly decreases post-traumatic brain swelling. When this paravascular system is blocked or becomes somehow dysfunctional, the “cleaning” and “cooling” functions of this system may be impaired or completely stopped. This could result in the accumulation of metabolic wastes that cannot be removed within these spaces. In addition, a faulty brain cooling system might play a role in the modification of the molecular structures of proteins, thereby making them more difficult to be removed by the flow of CSF, thus aggravating the situation. Therefore, this may be a common underlying mechanism for many neurodegenerative disorders, and an aggravation factor for others. This avenue appears to be novel and promising toward the elucidation and treatment of a host of diseases.
KeywordsVirchow Robin spaces Paravascular pathway Cleaning Cooling Cisternostomy Degenerative CNS diseases
Disclosure of Interests
The authors declare no conflict.
- Beltran M, Cherian I (2016) “Cooling and Cleaning” the brain – the role of CSF and the paravascular system. Int J Psychol Neurosci 2(1):1–14Google Scholar
- Cherian I, Beltran M (2016) Cisternostomy – introducing the concept of “CSF-shift edema”. Int J Psychol Neurosci 2(1):15–29Google Scholar
- Iliff JJ, Wang M, Liao Y, Plogg BA, Peng W, Gundersen GA, Benveniste H, Vates GE, Deane R, Goldman SA, Nagelhus EA, Nedergaard M (2012) A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid β. Sci Transl Med 4(147):147ra111CrossRefPubMedPubMedCentralGoogle Scholar
- Kida S (2014) Progress in diagnosis of and therapy for idiopathic normal-pressure hydrocephalus – lymphatic drainage of CSF and ISF from the brain: recent concept and hypothesis. Rinshō Shinkeigaku = Clin Neurol 54(12):1187–1189Google Scholar