Journal
NEUROLOGIA MEDICO-CHIRURGICA
Volume 55, Issue 8, Pages 647-656Publisher
JAPAN NEUROSURGICAL SOC
DOI: 10.2176/nmc.ra.2015-0003
Keywords
cerebrospinal fluid; choroid plexus; arachnoid granulation; lymphatic system; parenchymal capillary
Categories
Funding
- Ministry of Health, Labor, and Welfare of Japan [2012-Nanchi]
- Juntendo University Research Institute for Disease and Old Age
- [KAKENHI 23592106]
- [23592142]
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The traditional hypothesis of cerebrospinal fluid (CSF) hydrodynamics presumes that CSF is primarily produced in the choroid plexus (CP), then flows from the ventricles into the subarachnoid spaces, and mainly reabsorbed in the arachnoid granulations. This hypothesis is necessary to reconsider in view of recent research and clinical observations. This literature review presents numerous evidence for a new hypothesis of CSF hydrodynamics-(1) A significantly strong relationship exists between the CSF and interstitial fluid (IF), (2) CSF and IF are mainly produced and absorbed in the parenchymal capillaries of the brain and spinal cord. A considerable amount of CSF and IF are also absorbed by the lymphatic system, and (3) CSF movement is not unidirectional flow. It is only local mixing and diffusion.
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