Everything concerning cerebrospinal fluid anatomy and physiology

1. CEREBROSPINAL FLUID

2. Contents
DEFINITION OF CSF.
REGULATION OF CSF.
ANALYSIS OF CSF.
PATHOLOGY.4
1
2
3
The discussion will be according to the following plan.

3. HISTORY
400 BC 170
BC
14TH
CENT
URY
18TH CENTURY
• HERE ARE SOME OF THE ANCIENT PHYSICIANS WHO
PLAYED A BIG ROLE IN ELUCIDATING THE CEREBROSPINAL
FLUID.

4. CONTRIBUTORS.
Hippocrates
Galen
Magendie

5. What is CSF.
• Cerebrospinal fluid is a clear, colourless, ultra
filtrate of plasma located in the ventriculi of the
brain and also in spatium subarachnoidea
produced by the modified ependyma cells in
choroid plexus of the ventricles of brain.

7. Composition.
SUBSTANCE PLASMA CSF
Sodium (mEq/L) 140.0 144.0
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
Glucose (mg/dL) 110.0 50 - 80
Osmolality 0.3 0.29
pH 7.4 7.3
Pco2 (mmHg) 41.1 50.5

8. Constitution
Intracranial volumetric distribution of CSF, blood,
& brain parenchyma.
1400ml 150ml 120ml 30ml
BRAIN TISSUE CSF VENOUS BLOOD ARTERIAL BLOOD
A B C D

9. Volumetric distribution of CSF.
3rd Ventricle
4th Ventricle
Spinal sub-arachnoid space
Lat. Vent. Horns
Cranial Subarachnoid
Space.
2 - 3ml
2 - 3ml
25ml
25 - 30ml
100ml

10. Regulation ( secretion and
circulation).

11. REGULATION
(circulation and
absorption).
THE
CHOROID
PLEXUS.

12. FUNCTIONS.
CSF
PROTECTION
It Protects the brain from
minor stress such as
jolting.
BUOYANCY
It reduces the brain’s net
weight from 1.4kg to
0.025kg.
BLOOD PERFUSION
It increases intracranial
pressure hereby leading
to a greater brain
perfusion & preventing
ischemia
METHABOLIC
Trophic function for
brain.

13. CSF investigation
Ventricular puncture.
CSF aspiration methods
The needle is inserted through the
the ANt. Fontanelle & the CSF in
lateral ventricle is aspirated.
Puncture of the cerebromedullary
cistern.
•Most used method, involves
aspiration between L2 & L3
vertebrae.
Fontanelle Taps
Cisternal Taps
Ventricular Taps
Lumbar Puncture

14. Lumbar puncture.
• This is the withdrawal of cerebrospinal
fluid from the subarachnoid space in the
lumbar region, usually between the L3 &
L4 vertebrae for diagnostic or therapeutic
purposes.

15. Anomaly and Pathology involving CSF.
• Hydrocephalus.
• Leakage of Cerebrospinal Fluid.
• Xanthochromia.
• Meningitis.

16. Hydrocephalus.
• Hydrocephalus : This is due to overproduction,
obstruction or interference with CSF absorption
results in excess fluid in Cerebral ventricles and
enlargement of the head. The blockage is
usually at the aqueduct of Sylvius.
• The is treated by use of shunts connecting the
ventricles to abdomen or places where the fluid
can be absorbed also by surgically creating a
hole in the floor of 3rd ventricle.

17. Hydrocephalus.

18. Leakage of CSF.
• Fractures in the floor of middle cranial fossa
may result in the middle cranial fossa or
anterior cranial fossa may lead to leakage
from external acoustic meatus ( Otorrhea )
or leakage through the nose ( rhinorrhea )
respectively.
• This leakage shows increased risk of
meningitis.

19. Xanthochromia
 Yellow appearance of centrifuged CSF
resulting from red cell breakdown products
points towards subarachnoid haemorrhage
(SAH).

20. Meningitis
• Meningitis: this is inflammation of the
meninges, usually by either bacterial or
viral infections.
• Symptoms: Fever, headache, irritability,
vomiting, convulsions and coma.
• Treatment: Antibiotics are used.

21. Conclusion.
• Cerebrospinal fluid plays a role in not just
providing a suitable environment for the
• “ central processing unit “ ( brain ) but also
it is also important in diagnosis of various
diseases.

22. Thank You!