CSF

ANATOMY & PHYSIOLOGY

 WHAT IS CSF

It is a clear colorless uid.

Specific gravity of 1.007
pH of 7.337.35; Alkaline
Part of the ECF
Surrounds the brain and spinal cord, in the Subarachnoid Space
 FUNCTION

1. Cushions and protects the central nervous system from trauma

2. Provides mechanical support for the brain
3. Regulation of the contents of the skull
4. Nourishes the central nervous system
5. Removes metabolites from the central nervous system
6. Serves as a pathway for pineal secretions to reach the pituitary gland
7. Immunological function similar to the lymphatic system
 PRODUCTION

80% of CSF is produced by the choroid plexuses, located in both lateral

ventricles (accounts for 95%) and in the 4th ventricle.
Interstitial space
Ependymal lining of the ventricles
Dura of the nerve root sleeves
 SECRETION

The choroid plexus, is a

cauliflower-like growth of blood vessels covered by a thin layer of epithelial cells.
projects into the temporal horn of each lateral ventricle, the posterior portion of the
third ventricle, and the roof of the fourth ventricle.

Secretion depends mainly on active transport of sodium ions through the

epithelial cells lining the outside of the plexus.
The sodium ions in turn pull along large amounts of chloride ions as well because
the
positive charge of the sodium ion attracts the chloride ions negative charge.
osmosis of water through the membrane, thus providing the fluid of the secretion.
 Less important transport processes move small amounts of glucose into the
CSF and both K+ and bicarbonate ions out of the cerebrospinal fluid into the
capillaries.
The resulting characteristics of the CSF become:
osmotic pressure, approximately equal to that of plasma;
sodium ion concentration, also approximately equal to that of plasma;
chloride ion, about 15 percent greater than in plasma;
potassium ion, approximately 40 percent less; and
glucose, about 30 percent less.
 PROPERTIES

Rate of Formation: about 0.3 0.35 ml/min 450 - 750 ml/24hr

Average Volume: 150 ml
Turned over 3 times every day, 0.25% of total volume will be replaced each
minute.
The rate of formation is independent of the intracranial pressure.
(except in the limiting case when ICP becomes so high that CBF is reduced).
Normal CSF production, volumes, and pressure
Property Peds Adult
Newborn 1-10 yrs
Total Volume (ml) 5 50 150 (50% intracranial, 50% spinal)
Formation Rate 25 ml/d 0.30.35 ml/min ( 450750 ml/d)
pressure 9-12 mean: 10 adult: 715 (> 18 usually abnormal)
(cm of H2O) normal: < young adult: <1820
15
 CSF movement
Formation of CSF in lateral ventricles

Foramen of Monro

Third ventricle

Aqueductus Sylvius

Fourth ventricle

Foramen of magendie and foramen of

Luschka
Cisterna magna and Cisterna lateralis

Subarachnoid spaces

To the spinal cord To cerebral hemispheres

 CIRCULATION

CSF secreted in the lateral ventricles passes interventricular foramina (Monro) into the
third ventricle; through the aqueduct of Sylvius into the
fourth ventricle,
three small openings, two lateral foramina of Luschka and a midline foramen of
Magendie, entering the cisterna magna,
subarachnoid space
arachnoidal villi that project into the large sagittal venous sinus and other venous sinuses
of the cerebrum. Thus, any extra uid empties into the venous blood through pores of
these villi.
 The circulation is aided by the
arterial pulsations of the choroid plexuses and by the cilia on the ependymal cells
lining the ventricles.
pulsations of the cerebral arteries.
pulsations of the spinal arteries
movements of the vertebral column, respiration, coughing,
and changing of the positions of the body

So CSF movement is Pulsatile movement

A new hypothesis (2014) by Klarica and Oreskovic, suggests that there is no
unidirectional CSF circulation, but cardiac cycle-dependent bi-directional systolic-
diastolic to-and-fro cranio-spinal CSF movements
MRI showing pulsation of CSF
 ABSORPTION

Primarily by arachnoid villi that extend into the dural venous sinuses.
Choroid plexuses and lymphatics.
The rate of absorption is pressure dependent.
 The arachnoidal villi are microscopic fingerlike inward projections of the
arachnoidal membrane through the walls and into the venous sinuses.
especially the superior sagittal sinus, these villi form macroscopic
structures called arachnoidal granulations that can be seen protruding into
the sinuses.
The arachnoid granulations increase in number and size with age and tend to
become calcified with advanced age.
 The absorption of CSF into the venous sinuses occurs when the CSF pressure
exceeds the venous pressure in the sinus.
Electron-microscopic studies of the arachnoid villi indicate that fine tubules lined
with endothelium permit a direct flow of fluid from the subarachnoid space into
the lumen of the venous sinuses.
It also can be absorbed directly into the veins in the subarachnoid space,
and some possibly escapes through the perineural lymph vessels of the cranial
and spinal nerves.
rate of absorption of CSF, controls the CSF pressure.
 Cerebrospinal Fluid
Water - 99.13% Solids - 0.87%

Organic substances Inorganic

1.Proteins substances

2.Amino acids 1.Sodium

3.Sugar 2.Calcium

4.Cholesterol 3.Potassium
4.Magnesium
5.Urea
5.Chlorides
6.Uric acid
6.Phosphate
7.Creatinine
7.Bicarbonates
8.Lactic acid
8.Sulfates

Lymphocytes in CSF : 0-5 /

mm3
CSF VARIATIONS WITH AGE
Thank you