CEREBROSPINAL FLUID

Contents

DEFINITION OF CSF.

REGULATION OF CSF.

ANALYSIS OF CSF.

PATHOLOGY.4

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400 BC 170 BC

14TH CENTURY

18TH CENTURY

• HERE ARE SOME OF THE ANCIENT PHYSICIANS WHO PLAYED A BIG ROLE IN ELUCIDATING THE CEREBROSPINAL FLUID.

CONTRIBUTORS.Hippocrates

Galen

Magendie

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.

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

Constitution

Intracranial volumetric distribution of CSF, blood, & brain parenchyma.

1400ml 150ml 120ml 30ml

BRAIN TISSUEBRAIN TISSUE CSFCSF VENOUS BLOODVENOUS BLOOD ARTERIAL BLOODARTERIAL BLOOD

AA BB CC DD

Volumetric distribution of CSF.

3rd Ventricle

4th Ventricle

Spinal sub-arachnoid space

Lat. Vent. Horns

Cranial SubarachnoidSpace.

2 - 3ml

2 - 3ml

25ml

25 - 30ml

100ml

Regulation ( secretion and circulation).

REGULATION (circulation and absorption).

THE CHOROID PLEXUS.

FUNCTIONS.

CSFPROTECTION

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 PERFUSIONIt increases intracranial pressure hereby leading

to a greater brain perfusion & preventing

ischemia

METHABOLIC

Trophic function for brain.

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

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.

Anomaly and Pathology involving CSF.

• Hydrocephalus.• Leakage of Cerebrospinal Fluid.• Xanthochromia.• Meningitis.

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.

Hydrocephalus.

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.

Xanthochromia

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

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.

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.

Thank You!