Production , circulation and absorption of CSF Function of CSF Composition of CSF

The cerebrospinal fluid is formed mainly in the choroid plexuses of the lateral, third, and fourth ventricles Some originates from the ependymal cells lining the ventricles and from the brain substance through the perivascular spaces.

The circulation begins with its secretion from the choroid plexuses in the ventricles The fluid passes from the lateral ventricles into t third ventricle through the interventricular foramina It then passes into the fourth ventricle through the narrow cerebral aqueduct. The circulation is aided by the arterial pulsations of the choroid plexuses and by the cilia on the ependymal cells lining the ventricles. From the fourth ventricle, the fluid passes slowly through the median aperture and the lateral foramina of the lateral recesses of the fourth ventricle and enters the subarachnoid space

The fluid then moves through the cerebellomedullary cistern and pontine cisterns and flows superiorly through the tentorial notch of the tentorium cerebelli to reach the inferior surface of the cerebrum Some of the cerebrospinal fluid moves inferiorly in the sub arachnoid space around the spinal cord The cerebrospinal fluid not only bathes the ependymal and pial surfaces of the brain and spinal cord but also penetrates the nervous tissue along the blood vessels

The main sites for the absorption of the cerebrospinal fluid are the arachnoid villi that project into the dural venous sinuses, especially the superior sagittal sinus arachnoid villi which are group together are known as arachnoid granulations Structural. each arachnoid villus is a diverticulum of the subarachnoid space that pierces the dura mater. The arachnoid diverticulum is capped by a thin cellular layer, which, in turn, is covered by the endothelium of the venous sinus

Arachnoid villi

The normal pressure of CSF is 10 mmHg

Regulation of CSF by the arachnoidal villi It work as one way valve to allow CSF to flow into the blood venous sinus and at the same time, it prevent the blood to flow backward in the opposite direction The villi allow CSF to flow into the blood when CSF pressure is 1.5 mmHg or more greater than the pressure in the blood venous sinus .

Increase of CSF pressure often caused by large tumor that elevate the CSF pressure by decreasing reabsorption of CSF back into the blood .
CSF pressure also rises when there is presence of hemorrhage or infection . In this case, large number of red and white blood cells appear in CSF and they can cause blockage of small absorption channels through the arachnoidal villi . Some congenital condition may cause high pressure of CSF caused by few number of arachnoid villi or abnormal properties of the villi

Accumulation of cerebrospinal fluid (CSF) in the ventricles, or cavities, of the brain .

Two types : Communicating hydrocephalous : In communicating type, blockage is in the subarchnoid space by blockage of arachnoidal villi themselves .

Non communicating : Fluid can not pass to the subarachnoid space In this type,the blockage present in the Aqueduct of Sylvius .

Obstruction of villi blockage CSF pressure hydrocephalous may lead to edema .

Cushion and protect the CNS from trauma. Provides mechanical buoyancy and support for the brain Serves as reservoir and assistant in the regulation of the content of the skull Nourishes the brain

Remove metabolic wastes from CNS Serves as pathway for pineal secretion to reach the pituitary gland. it protects against acute changes in arterial and venous blood pressure. it is involved in intra-cerebral transport, eg. hypothalamic hormones

In addition to the major ions, CSF contains oxygen, sugars (e.g., glucose, fructose, polyols), lactate, proteins (e.g., albumin, globulins), amino acids, urea, ammonia, creatinine, lipids, hormones (e.g., insulin), and vitamins.

Substance Sodium (mEq/L) 140.0

Plasma 144.0

CSF

Potassium (mm/L)

4.6

2.9

Magnesium (mEq/L)

1.6

2.2

Calcium (mg/dL)

8.9

4.6

Chloride (mEq/L)

99.0

113.0

Bicarbonate (mm/L)

26.8

23.3

Inorganic phosphate (mg/dL)

4.7

3.4

Protein (g/dL)

6.8

0.028 (28mg/dL)

Glucose (mg/dL)

110.0

50 to 80

Osmolality

0.3

0.29

pH

7.4

7.3

PCO2 (mmHg)

41.1

50.5