scholarly journals The Brain-Nose Interface: A Potential Cerebrospinal Fluid Clearance Site in Humans

2022 ◽  
Vol 12 ◽  
Author(s):  
Neel H. Mehta ◽  
Jonah Sherbansky ◽  
Angela R. Kamer ◽  
Roxana O. Carare ◽  
Tracy Butler ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Animal Species ◽  
Immune Surveillance ◽  
Cranial Nerves ◽  
Extracellular Fluid ◽  
Olfactory Nerve ◽  
Brain Functions ◽  
Treatment Considerations ◽  
Physiological Homeostasis ◽  
The Brain

The human brain functions at the center of a network of systems aimed at providing a structural and immunological layer of protection. The cerebrospinal fluid (CSF) maintains a physiological homeostasis that is of paramount importance to proper neurological activity. CSF is largely produced in the choroid plexus where it is continuous with the brain extracellular fluid and circulates through the ventricles. CSF movement through the central nervous system has been extensively explored. Across numerous animal species, the involvement of various drainage pathways in CSF, including arachnoid granulations, cranial nerves, perivascular pathways, and meningeal lymphatics, has been studied. Among these, there is a proposed CSF clearance route spanning the olfactory nerve and exiting the brain at the cribriform plate and entering lymphatics. While this pathway has been demonstrated in multiple animal species, evidence of a similar CSF egress mechanism involving the nasal cavity in humans remains poorly consolidated. This review will synthesize contemporary evidence surrounding CSF clearance at the nose-brain interface, examining across species this anatomical pathway, and its possible significance to human neurodegenerative disease. Our discussion of a bidirectional nasal pathway includes examination of the immune surveillance in the olfactory region protecting the brain. Overall, we expect that an expanded discussion of the brain-nose pathway and interactions with the environment will contribute to an improved understanding of neurodegenerative and infectious diseases, and potentially to novel prevention and treatment considerations.

Unknown fatal encephalomyelopolyradiculoneuritis in a child. A case report

2021 ◽  
Vol 2 (2) ◽  
pp. 100-106
Author(s):  
Aleksandra I. Pavlyuchkova ◽  
Aleksey S. Kotov
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Genetic Diseases ◽  
Cranial Nerves ◽  
Unknown Etiology ◽  
Active Therapy ◽  
Nerve Roots ◽  
Child Patient ◽  
Brain And Spinal Cord ◽  
The Brain

In childhood, various infectious, autoimmune, genetic diseases can manifest. We present a case of fatal encephalomyelopolyradiculoneuritis of unknown etiology in a 9-year-old child. Patient N.K. in February 2019, noted an increase in temperature to subfebrile values, received symptomatic and antibiotic therapy without effect. An increase in protein and lymphocytes was found in the cerebrospinal fluid. According to MRI data, the emergence of more and more foci of the pathological signal in the brain and spinal cord, cranial nerves and nerve roots of the lumbar plexus was noted. Known infectious and autoimmune diseases were excluded. Despite active therapy with glucocorticoids, antibiotics, antiviral drugs, immunoglobulin, the disease continued to progress, and the patient died in April 2020.

Cerebrospinal fluid formation and absorption in dehydrated sheep

1998 ◽  
Vol 275 (2) ◽  
pp. F235-F238 ◽  
Author(s):  
Adam Chodobski ◽  
Joanna Szmydynger-Chodobska ◽  
Michael J. McKinley
Keyword(s):  
Cerebrospinal Fluid ◽  
Adaptive Response ◽  
Venous Pressure ◽  
Extracellular Fluid ◽  
Cerebral Ventricles ◽  
Central Venous ◽  
Ventriculocisternal Perfusion ◽  
Fluid Formation ◽  
The Brain ◽  
Csf Production

Cerebrospinal fluid (CSF) plays an important role in the brain’s adaptive response to acute osmotic disturbances. In the present experiments, the effect of 48-h dehydration on CSF formation and absorption rates was studied in conscious adult sheep. Animals had cannulas chronically implanted into the lateral cerebral ventricles and cisterna magna to enable the ventriculocisternal perfusion. A 48-h water deprivation altered neither CSF production nor resistance to CSF absorption. However, in the water-depleted sheep, intraventricular pressure tended to be lower than that found under control conditions. This likely resulted from decreased extracellular fluid volume and a subsequent drop in central venous pressure occurring in dehydrated animals. In conclusion, our findings provide evidence for the maintenance of CSF production during mild dehydration, which may play a role in the regulation of fluid balance in the brain during chronic hyperosmotic stress.

The Transoral Approach for the Management of Intradural Lesions at the Craniovertebral Junction: Review of 7 Cases

Neurosurgery ◽  
1991 ◽  
Vol 28 (1) ◽  
pp. 88-98 ◽  
Author(s):  
Alan H. Crockard ◽  
Chandra N. Sen
Keyword(s):  
Cerebrospinal Fluid ◽  
Cranial Nerves ◽  
Craniovertebral Junction ◽  
Transoral Approach ◽  
Cerebrospinal Fluid Leakage ◽  
Main Difficulty ◽  
Fibrin Adhesive ◽  
Vertebral Arteries ◽  
Brain Retraction ◽  
The Brain

Abstract The main difficulty in dealing with intradural lesions located ventrally in the region of the craniovertebral junction (CVJ) is related to their relative inaccessibility. Posterolateral approaches involve some manipulation of the brain stem and provide limited access because of the necessity of working between the cranial nerves. Even then, the view of the ventral midline and across is limited. The transoral approach, which has been widely used for the management of extradural lesions in this area, is also useful for the treatment of intradural lesions. It provides an unimpeded although somewhat restricted, view of the ventral aspect of the CVJ without the need for brain retraction. The cranial nerves and vertebral arteries are not interposed between the surgeon and the lesion. The risks of cerebrospinal fluid leakage and infection are greatly diminished by the use of fibrin adhesive and prolonged diversion of the cerebrospinal fluid. The use of this approach, together with its technical difficulties and results, in the management of seven purely intradural lesions located ventrally at the CVJ, is discussed.

Cerebrospinal Fluid, Brain Electrolytes Balance, and the Unsuspected Intrinsic Property of Melanin to Dissociate the Water Molecule

2018 ◽  
Vol 17 (10) ◽  
pp. 743-756 ◽  
Author(s):  
Arturo Solís Herrera ◽  
Ghulam Md Ashraf ◽  
María del Carmen Arias Esparza ◽  
Vadim V. Tarasov ◽  
Vladimir N. Chubarev ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Extracellular Fluid ◽  
Intrinsic Property ◽  
Fluid Secretion ◽  
Current View ◽  
Formidable Challenge ◽  
Fluid Production ◽  
Fluid Transfer ◽  
The Brain

Background & Objective: Regulation of composition, volume and turnover of fluids surrounding the brain and damp cells is vital. These fluids transport all substances required for cells and remove the unwanted materials. This regulation tends to act as barrier to prevent free exchange of materials between the brain and blood. There are specific mechanisms concerned with fluid secretion of the controlled composition of the brain, and others responsible for reabsorption eventually to blood and the extracellular fluid whatever their composition is. The current view assumes that choroidal plexuses secrete the major part of Cerebrospinal Fluid (CSF), while the Blood-Brain Barrier (BBB) has a much less contribution to fluid production, generating Interstitial Fluid (ISF) that drains to CSF. The skull is a rigid box; thereby the sum of volumes occupied by the parenchyma with its ISF, related connective tissue, the vasculature, the meninges and the CSF must be relatively constant according to the Monroe-Kellie dogma. This constitutes a formidable challenge that normal organisms surpass daily. The ISF and CSF provide water and solutes influx and efflux from cells to these targeted fluids in a quite precise way. Microvessels within the parenchyma are sufficiently close to every cell where diffusion areas for solutes are tiny. Despite this, CSF and ISF exhibit very similar compositions, but differ significantly from blood plasma. Many hydrophilic substances are effectively prevented from the entry into the brain via blood, while others like neurotransmitters are extremely hindered from getting out of the brain. Anatomical principle of the barrier and routes of fluid transfer cannot explain the extraordinary accuracy of fluids and substances needed to enter or leave the brain firmly. There is one aspect that has not been deeply analyzed, despite being prevalent in all the above processes, it is considered a part of the CSF and ISF dynamics. This aspect is the energy necessary to propel them properly in time, form, space, quantity and temporality. Conclusion: The recent hypothesis based on glucose and ATP as sources of energy presents numerous contradictions and controversies. The discovery of the unsuspected intrinsic ability of melanin to dissociate and reform water molecules, similar to the role of chlorophyll in plants, was confirmed in the study of ISF and CSF biology.

Survey on Olfactory Testing by Pediatric Neurologists: Is the Olfactory a “True” Cranial Nerve?

2020 ◽  
Vol 35 (5) ◽  
pp. 317-321 ◽  
Author(s):  
Harvey B. Sarnat ◽  
Laura Flores-Sarnat
Keyword(s):  
North American ◽  
Cranial Nerve ◽  
Genetic Disorders ◽  
Genetic Diseases ◽  
Cranial Nerves ◽  
The United States ◽  
Olfactory Nerve ◽  
Multiple Choice Questions ◽  
Olfactory Testing ◽  
The Brain

Background: The olfactory nerve was conceptualized in the 4th century BC by Alcmaeon and described anatomically by Winslow in 1733. Cranial nerves (CNs) were named and numbered by Soemmerring in 1791. Notions still prevail that the olfactory (CN1) is not a “true” cranial nerve. Methods: To confirm our impression that the olfactory nerve is infrequently tested by North American pediatric neurologists, a survey was distributed to members of national pediatric neurology societies in Mexico, Canada, and the United States. A total of 233 responses were received to 6 multiple-choice questions regarding practice patterns examining CN1 in neonates and children and in metabolic, endocrine, and genetic disorders and cerebral malformations. Two of the questions addressed familiarity with neonatal olfactory reflexes and asked whether the olfactory is a “true” cranial nerve. Results: Only 16% to 24% of North American pediatric neurologists examine CN1 in neonates, even in conditions in which olfaction may be impaired. About 40% of respondents were aware of olfactory reflexes. A minority 15% did not consider CN1 as a “true” cranial nerve. Conclusions: Olfactory evaluation in neonates is simple, rapid, and inexpensive. It tests parts of the brain not otherwise examined. It may assist diagnosis in cerebral malformations; metabolic, endocrine, and hypoxic encephalopathies; and some genetic diseases, including chromosomopathies. CN1 is neuroanatomically unique and fulfills criteria of a true sensory cranial nerve. We recommend that olfaction be routinely or selectively included during neurologic examination of neonates and children.

Monitoring retraction pressure on the brain

1987 ◽  
Vol 66 (2) ◽  
pp. 270-275 ◽  
Author(s):  
Kazuhiro Hongo ◽  
Shigeaki Kobayashi ◽  
Akira Yokoh ◽  
Kenichiro Sugita
Keyword(s):  
Cerebrospinal Fluid ◽  
Strain Gauge ◽  
Cranial Nerves ◽  
Head Position ◽  
Cerebrospinal Fluid Drainage ◽  
Content Type ◽  
Attenuation Rate ◽  
Brain Retraction ◽  
The Brain ◽  
Fine Print

✓ The problem of minimizing tissue damage during brain retraction was studied both experimentally in dogs and clinically with the aid of newly designed strain-gauge retractor. The pressure required to obtain a specific exposure decreased gradually with time. The average time for a 50% reduction in retraction pressure was 6.6 minutes in the earlier trials of repeated retraction. The attenuation rate of retraction pressure gradually decreased when retraction of the same area was repeated. The lower the head position of the dog, the larger was the amplitude of brain retraction pressure. Clinical studies demonstrated that: 1) cerebrospinal fluid drainage was effective in decreasing the retraction pressure required; 2) use of multiple retractors reduced the pressure applied by each retractor; and 3) retraction pressure could be monitored when the strain-gauge retractors were applied to arteries and cranial nerves.

scholarly journals Metabolic mechanisms of development and compensation of osmotic stress in the brain

2017 ◽  
Vol 14 (4) ◽  
pp. 73-76 ◽  
Author(s):  
Ekaterina A. Pigarova ◽  
Larisa K. Dzeranova
Keyword(s):  
Cerebrospinal Fluid ◽  
Osmotic Stress ◽  
Interstitial Fluid ◽  
Rapid Change ◽  
Extracellular Fluid ◽  
Plasma Osmolality ◽  
Compensatory Mechanisms ◽  
Passive Permeability ◽  
Mechanisms Of Development ◽  
The Brain

Extracellular fluid of the brain, consisting of cerebrospinal fluid and interstitial fluid, is normally isotonic to blood plasma. Problems arise with a rapid change in osmolality of circulating blood or interstitial brain fluid. The permeability of the blood-brain barrier is lower than in the peripheral capillaries, but this permeability is still several times greater than the passive permeability for electrolytes or glucose. Because of this difference, it is believed that the brain is like an osmometer: it swells with reduced plasma osmolality and contracts (dehydrated) when the plasma becomes hypertonic. Osmotic stress has a direct effect on the functioning of the brain and triggers physiological compensatory mechanisms, in the absence of which due to the intensity or duration of stress, irreversible serious complications may develop. Knowledge and understanding of these processes are the basis for preventing their development and treatment.

The neuropsychological function of the 12 cranials nerves

2011 ◽  
Vol 26 (S2) ◽  
pp. 417-417
Author(s):  
S. Frohlich ◽  
C.A. Franco
Keyword(s):  
Cranial Nerve ◽  
Cranial Nerves ◽  
Olfactory Nerve ◽  
Spinal Nerve ◽  
Neuropsychological Function ◽  
Trochlear Nerve ◽  
Abducent Nerve ◽  
Behavioral Attitudes ◽  
The Brain ◽  
Cognitive Attitude

The cranial nerves can be an important key for research in Neuropsychology. Our hypothesis is that they can be organized in three groups and then, related to specifics attitudes.The Cochlear Nerve (VII pair), the Optic Nerve (II pair) and the olfactory nerve (I pair) have special translators that process the sensorial information from the environment to the brain, to form a clue. They are the first cranial nerve group: the cognitive nerves that incite the nervous system in an endogenous way. The second cranial nerve group stimulates muscles: the spinal nerve (XI pair) that regulates the posture, the trigeminal nerve (V pair) that is connected to mastication muscles and the hypoglossal nerve (XII pair) that supplies motor fibers for all the tongue muscles. They are behavioral nerves and act in an exogenous way.The third cranial nerve group regulates the emotions and is connected to the SNA: the Vagus nerve (X pair), the Facial nerve (VII pair) and the Glossofaringeal nerve (IX pair).The cranial nerves that enervate the eyes muscles are responsible for the regulation of the visual focus and the attention. We related them to the three groups above described. The Trochlear nerve (IV pair) incite a cognitive attitude and act in an endogenous way; the Abducent nerve (VI pair) produces the plain environmental attention through the saccades and following eyes movement and produces behavioral attitudes and the Oculomotor Nerve (III pair) act in autonomic way, regulating the inner feelings and emotions.

Fibrinolytic Activity of Cerebro-Spinal Fluid and the Development of Artificial Cerebral Haematomas in Dogs

1969 ◽  
Vol 21 (02) ◽  
pp. 294-303 ◽  
Author(s):  
H Mihara ◽  
T Fujii ◽  
S Okamoto
Keyword(s):  
Cerebrospinal Fluid ◽  
Carboxylic Acid ◽  
Fibrinolytic Activity ◽  
Clinical Implications ◽  
Trans Form ◽  
Plate Method ◽  
Blood Samples ◽  
Fibrin Plate ◽  
The Brain

SummaryBlood was injected into the brains of dogs to produce artificial haematomas, and paraffin injected to produce intracerebral paraffin masses. Cerebrospinal fluid (CSF) and peripheral blood samples were withdrawn at regular intervals and their fibrinolytic activities estimated by the fibrin plate method. Trans-form aminomethylcyclohexane-carboxylic acid (t-AMCHA) was administered to some individuals. Genera] relationships were found between changes in CSF fibrinolytic activity, area of tissue damage and survival time. t-AMCHA was clearly beneficial to those animals given a programme of administration. Tissue activator was extracted from the brain tissue after death or sacrifice for haematoma examination. The possible role of tissue activator in relation to haematoma development, and clinical implications of the results, are discussed.

Vasopressin enhances the clearance of β-endorphin immunoreactivity from rat cerebrospinal fluid

1990 ◽  
Vol 122 (2) ◽  
pp. 191-200 ◽  
Author(s):  
C. G. J. Sweep ◽  
Margreet D. Boomkamp ◽  
István Barna ◽  
A. Willeke Logtenberg ◽  
Victor M. Wiegant
Keyword(s):  
Cerebrospinal Fluid ◽  
Receptor Antagonist ◽  
Short Duration ◽  
Lateral Ventricle ◽  
Underlying Mechanism ◽  
Terminal Phase ◽  
Intracerebroventricular Injection ◽  
Intracerebroventricular Administration ◽  
Biphasic Pattern ◽  
The Brain

Abstract The effect of intracerebroventricular (lateral ventricle) administration of arginine8-vasopressin (AVP) on the concentration of β-endorphin immunoreactivity in the cerebrospinal fluid obtained from the cisterna magna was studied in rats. A decrease was observed 5 min following injection of 0.9 fmol AVP. No statistically significant changes were found 5 min after intracerebroventricular treatment of rats with 0.09 or 9 fmol. The decrease induced by 0.9 fmol AVP was of short duration and was found 5 min after treatment but not 10 and 20 min. Desglycinamide9-AVP (0.97 fmol), [pGlu4, Cyt6]-AVP-(4–9) (1.44 fmol), Nα-acetyl-AVP (0.88 fmol), lysine8-vasopressin (0.94 fmol) and oxytocin (1 fmol) when intracerebroventricularly injected did not affect the levels of β-endorphin immunoreactivity in the cerebrospinal fluid 5 min later. This suggests that the intact AVP-(1–9) molecule is required for this effect. Intracerebroventricular pretreatment of rats with the vasopressin V1-receptor antagonist d(CH2)5Tyr(Me)AVP (8.63 fmol) completely blocked the effect of AVP (0.9 fmol). In order to investigate further the underlying mechanism, the effect of AVP on the disappearance from the cerebrospinal fluid of exogenously applied β-endorphin was determined. Following intracerebroventricular injection of 1.46 pmol camel β-endorphin-(1–31), the β-endorphin immunoreactivity levels in the cisternal cerebrospinal fluid increased rapidly, and reached peak values at 10 min. The disappearance of β-endorphin immunoreactivity from the cerebrospinal fluid then followed a biphasic pattern with calculated half-lifes of 28 and 131 min for the initial and the terminal phase, respectively. Treatment of rats with AVP (0.9 fmol; icv) during either phase (10, 30, 55 min following intracerebroventricular administration of 1.46 pmol β-endorphin-(1–31)) significantly enhanced the disappearance of β-endorphin immunoreactivity from the cerebrospinal fluid. The data suggest that vasopressin plays a role in the regulation of β-endorphin levels in the cerebrospinal fluid by modulating clearance mechanisms via V1-receptors in the brain.

Sign in / Sign up

Export Citation Format

Share Document