Does neonatal cerebrospinal fluid absorption occur via arachnoid projections or extracranial lymphatics?

2002 ◽  
Vol 283 (4) ◽  
pp. R869-R876 ◽  
Author(s):  
C. Papaiconomou ◽  
R. Bozanovic-Sosic ◽  
A. Zakharov ◽  
M. Johnston
Keyword(s):  
Cerebrospinal Fluid ◽  
Constant Pressure ◽  
Cribriform Plate ◽  
Outflow Resistance ◽  
Arachnoid Villi ◽  
Relative Paucity ◽  
Stage Of Development ◽  
Cerebrospinal Fluid Absorption ◽  
Essential Function ◽  
Lymphatic Pathways

Arachnoid villi and granulations are thought to represent the primary sites where cerebrospinal fluid (CSF) is absorbed. However, these structures do not appear to exist in the fetus but begin to develop around the time of birth and increase in number with age. With the use of a constant pressure-perfusion system in 2- to 6-day-old lambs, we observed that global CSF transport (0.012 ± 0.003 ml · min−1 · cmH2O−1) and CSF outflow resistance (96.5 ± 17.8 cmH2O · ml−1 · min) were very similar to comparable measures in adult animals despite the relative paucity of arachnoid villi at this stage of development. In the neonate, the recovery patterns of a radioactive protein CSF tracer in various lymph nodes and tissues indicated that CSF transport occurred through multiple lymphatic pathways. An especially important route was transport through the cribriform plate into extracranial lymphatics located in the nasal submucosa. To investigate the importance of the cribriform route in cranial CSF clearance, the cranial CSF compartment was isolated surgically from its spinal counterpart. When the cribriform plate was sealed extracranially under these conditions, CSF transport was impaired significantly. These data demonstrate an essential function for lymphatics in neonatal CSF transport and imply that arachnoid projections may play a limited role earlier in development.

Cerebrospinal fluid absorption disorder of arachnoid villi in a canine model of hydrocephalus

2010 ◽  
Vol 58 (3) ◽  
pp. 371 ◽  
Author(s):  
BoYong Mao ◽  
Heng Zhang ◽  
Ke Zhao ◽  
Hong Sun ◽  
Yan Shan
Keyword(s):  
Cerebrospinal Fluid ◽  
Canine Model ◽  
Fluid Absorption ◽  
Arachnoid Villi ◽  
Cerebrospinal Fluid Absorption

Contribution of extracranial lymphatics and arachnoid villi to the clearance of a CSF tracer in the rat

1999 ◽  
Vol 276 (3) ◽  
pp. R818-R823 ◽  
Author(s):  
M. Boulton ◽  
M. Flessner ◽  
D. Armstrong ◽  
R. Mohamed ◽  
J. Hay ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Human Serum Albumin ◽  
Protein Complex ◽  
Evans Blue ◽  
Blue Dye ◽  
Intracerebroventricular Injection ◽  
Arachnoid Villi ◽  
Arterial Blood ◽  
Tracer Recovery ◽  
Lymphatic Pathways

The objective of this study was to determine the relative roles of arachnoid villi and cervical lymphatics in the clearance of a cerebrospinal fluid (CSF) tracer in rats.125I-labeled human serum albumin (125I-HSA; 100 μg) was injected into one lateral ventricle, and an Evans blue dye-rat protein complex was injected intravenously. Arterial blood was sampled for 3 h. Immediately after this, multiple cervical vessels were ligated in the same animals, and plasma recoveries were monitored for a further 3 h after the intracerebroventricular injection of 100 μg131I-HSA. Tracer recovery in plasma at 3 h averaged (%injected dose) 0.697 ± 0.042 before lymphatic ligation and dropped significantly to 0.357 ± 0.060 after ligation. Estimates of the rate constant associated with the transport of the CSF tracer to plasma were also significantly lower after obstruction of cervical lymphatics (from 0.584 ± 0.072/h to 0.217 ± 0.056/h). No significant changes were observed in sham-operated animals. Assuming that the movement of the CSF tracer to plasma in lymph-ligated animals was a result of arachnoid villi clearance, we conclude that arachnoid villi and extracranial lymphatic pathways contributed equally to the clearance of the CSF tracer from the cranial vault.

Intracranial pressure accommodation is impaired by blocking pathways leading to extracranial lymphatics

2001 ◽  
Vol 280 (5) ◽  
pp. R1573-R1581 ◽  
Author(s):  
R. Mollanji ◽  
R. Bozanovic-Sosic ◽  
I. Silver ◽  
B. Li ◽  
C. Kim ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Cribriform Plate ◽  
Transport Pathways ◽  
Conventional View ◽  
Arachnoid Villi ◽  
Before And After ◽  
Intracranial Pressures ◽  
Flow Through ◽  
Mucosal Side ◽  
Lymphatic Pathways

Tracer studies indicate that cerebrospinal fluid (CSF) transport can occur through the cribriform plate into the nasal submucosa, where it is absorbed by cervical lymphatics. We tested the hypothesis that sealing the cribriform plate extracranially would impair the ability of the CSF pressure-regulating systems to compensate for volume infusions. Sheep were challenged with constant flow or constant pressure infusions of artificial CSF into the CSF compartment before and after the nasal mucosal side of the cribriform plate was sealed. With both infusion protocols, the intracranial pressure (ICP) vs. flow rate relationships were shifted significantly to the left when the cribriform plate was blocked. This indicated that obstruction of the cribriform plate reduced CSF clearance. Sham surgical procedures had no significant effects. Estimates of the proportional flow through cribriform and noncribriform routes suggested that cranial CSF absorption occurred primarily through the cribriform plate at low ICPs. Additional drainage sites (arachnoid villi or other lymphatic pathways) appeared to be recruited only when intracranial pressures were elevated. These data challenge the conventional view that CSF is absorbed principally via arachnoid villi and provide further support for the existence of several anatomically distinct cranial CSF transport pathways.

Blocking cerebrospinal fluid absorption through the cribriform plate increases resting intracranial pressure

2002 ◽  
Vol 282 (6) ◽  
pp. R1593-R1599 ◽  
Author(s):  
R. Mollanji ◽  
R. Bozanovic-Sosic ◽  
A. Zakharov ◽  
L. Makarian ◽  
M. G. Johnston
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Cribriform Plate ◽  
Olfactory Pathway ◽  
Major Site ◽  
Tissue Glue ◽  
Adjacent Mucosa ◽  
Before And After ◽  
Cerebrospinal Fluid Absorption ◽  
Experimental Group

Cerebrospinal fluid (CSF) drains through the cribriform plate (CP) in association with the olfactory nerves. From this location, CSF is absorbed into nasal mucosal lymphatics. Recent data suggest that this pathway plays an important role in global CSF transport in sheep. In this report, we tested the hypothesis that blocking CSF transport through this pathway would elevate resting intracranial pressure (ICP). ICP was measured continuously from the cisterna magna of sheep before and after CP obstruction in the same animal. To block CSF transport through the CP, an external ethmoidectomy was performed. The olfactory and adjacent mucosa were removed, and the bone surface was sealed with tissue glue. To restrict our analysis to the cranial CSF system, CSF transport into the spinal subarachnoid compartment was prevented with a ligature tightened around the thecal sac between C1 and C2. Sham surgical procedures had no significant effects, but in the experimental group CP obstruction elevated ICP significantly. Mean postobstruction steady-state pressures (18.0 ± 3.8 cmH2O) were approximately double the preobstruction values (9.2 ± 0.9 cmH2O). These data support the concept that the olfactory pathway represents a major site for CSF drainage.

Mechanisms of Cerebrospinal Fluid Absorption in Normal and Pathologically Altered Arachnoid Villi

1983 ◽  
pp. 707-726 ◽  
Author(s):  
Albert B. Butler ◽  
Ralph G. Dacey ◽  
Charles J. Maffeo ◽  
J. Douglas Mann ◽  
Richard N. Johnson ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Fluid Absorption ◽  
Arachnoid Villi ◽  
Cerebrospinal Fluid Absorption

scholarly journals Determination of volumetric cerebrospinal fluid absorption into extracranial lymphatics in sheep

1998 ◽  
Vol 274 (1) ◽  
pp. R88-R96 ◽  
Author(s):  
M. Boulton ◽  
M. Flessner ◽  
D. Armstrong ◽  
J. Hay ◽  
M. Johnston
Keyword(s):  
Cerebrospinal Fluid ◽  
Jugular Vein ◽  
Lymphatic Vessels ◽  
Balance Equations ◽  
Arachnoid Villi ◽  
Lateral Ventricles ◽  
Cerebrospinal Fluid Absorption ◽  
Conscious Sheep ◽  
Csf Absorption

We estimated the volumetric clearance of cerebrospinal fluid (CSF) through arachnoid villi and extracranial lymphatics in conscious sheep. Catheters were inserted into both lateral ventricles, the cisterna magna, multiple cervical lymphatics, thoracic duct, and jugular vein. Uncannulated cervical vessels were ligated.125I-labeled human serum albumin (HSA) was administered into both lateral ventricles.131I-HSA was injected intravenously to permit calculation of plasma tracer loss and tracer recirculation into lymphatics. From mass balance equations, total volumetric absorption of CSF averaged 3.37 ± 0.38 ml/h, with 2.03 ± 0.29 ml/h (∼60%) removed by arachnoid villi and 1.35 ± 0.46 ml/h (∼40%) cleared by lymphatics. With projected estimates for noncannulated ducts, total CSF absorption increased to 3.89 ± 0.33 ml/h, with 1.86 ± 0.49 ml/h (48%) absorbed by lymphatics. Additionally, we calculated total CSF drainage to be 3.48 ± 0.52 ml/h, with 54 and 46% removed by arachnoid villi and lymphatics, respectively, using previously published mass transport data from our group. We employed estimates of CSF tracer concentrations that were extrapolated from relationships observed in the study reported here. We conclude that 40–48% of the total volume of CSF absorbed from the cranial compartment is removed by extracranial lymphatic vessels.

Differentiated approach to plastic surgery of cerebrospinal fluid fistulas in the cribriform plate on the analysis of computed tomograms.

2021 ◽  
Vol 27 (3) ◽  
pp. 22-35
Author(s):  
E.V. Shelesko ◽  
N.A. Chernikova ◽  
Y.V. Strunina ◽  
S.D. Nikonova ◽  
A.H. Abdulgamidov ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Plastic Surgery ◽  
Cribriform Plate

scholarly journals Iatrogenic cerebrospinal fluid leak after repeated nasal swab tests for COVID-19: illustrative case

2021 ◽  
Vol 2 (17) ◽  
Author(s):  
Johnson Ku ◽  
Chieh-Yi Chen ◽  
Jason Ku ◽  
Hsuan-Kan Chang ◽  
Jau-Ching Wu ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Nasal Cavity ◽  
Nasal Swab ◽  
Cerebrospinal Fluid Leak ◽  
Cribriform Plate ◽  
Csf Leak ◽  
Illustrative Case ◽  
Endoscopic Endonasal ◽  
Csf Rhinorrhea ◽  
Csf Leakage

BACKGROUND Nasal swab tests are one of the most essential tools for screening coronavirus disease 2019 (COVID-19). The authors report a rare case of iatrogenic cerebrospinal fluid (CSF) leak from the anterior skull base after repeated nasal swab tests for COVID-19, which was treated with endoscopic endonasal repair. OBSERVATIONS A 41-year-old man presented with clear continuous rhinorrhea through his left nostril for 5 days after repeated nasal swabbing for COVID-19. There were no obvious risk factors for spontaneous CSF leak. Computed tomography cisternography showed contrast accumulation in the left olfactory fossa and along the left nasal cavity. Such findings aligned with a preliminary diagnosis of CSF leakage through the left cribriform plate. Magnetic resonance imaging confirmed the presence of a CSF fistula between his left cribriform plate and superior nasal concha. The patient underwent endoscopic endonasal repair. CSF rhinorrhea ceased after the surgery, and no recurrence was noted during the 12-week postoperative follow-up period. LESSONS Although rare, iatrogenic CSF leakage can be a serious complication following COVID-19 nasal swab tests, especially when infection may cause significant neurological sequelae. Healthcare providers should become familiar with nasal cavity anatomy and be well trained in performing nasal swab tests.

Dynamic properties of lymphatic pathways for the absorption of cerebrospinal fluid

1997 ◽  
Vol 94 (5) ◽  
pp. 493-498 ◽  
Author(s):  
T. Brinker ◽  
W. Lüdemann ◽  
D. Berens von Rautenfeld ◽  
M. Samii
Keyword(s):  
Cerebrospinal Fluid ◽  
Dynamic Properties ◽  
Lymphatic Pathways
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