CEREBROSPINAL FLUID
Contents
DEFINITION OF CSF.
REGULATION OF CSF.
ANALYSIS OF CSF.
PATHOLOGY.4
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The discussion will be according to the following plan.
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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.
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
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.
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.