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Disorders of Circulation of the Cerebrospinal Fluid
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Bulk flow of CSF occurs due to a gradient from the site of production in the choroid plexus to its resorption over the convexities in the arachnoid villi. The choroid plexus mainly resides in the roof of the third ventricle and the floors of the lateral ventricles with smaller areas in the temporal lobes and the fourth ventricle. The rate of CSF production in the choroid plexus is approximately 0.35 mL/min or 500 mL/24 h, and CSF flows from the lateral and third ventricle, through the cerebral aqueduct and into the fourth ventricle. From the fourth ventricle, CSF exits the ventricular compartment via the foramen of Magendie and Luschka and enters the extra-axial subarachnoid space around the brain, and communicates with the subarachnoid space around the spinal cord.1 CSF is absorbed back into the superior sagittal sinus through the arachnoid villi, via a valve-like one-way mechanism that prevents sinus blood from entering into the subarachnoid space (Figure 20.1). Resorption of CSF at the arachnoid villi requires a positive pressure in the subarachnoid space of at least 6 cmH2O. At CSF pressures of < 6 cmH2O, resorption probably does not occur at the arachnoid villi. Normal CSF pressure in the recumbent position is 6–20 cmH2O.
The patient with acute neurological problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
CSF is a colourless, clear liquid produced by a network of capillaries called the choroid plexus in the walls of all four ventricles within the brain. The choroid plexus is surrounded by ependymal cells (glial cells) that continuously generate CSF from the plasma of the blood by a process of filtration and secretion. As well as a blood–brain barrier, the brain also has a blood–CSF barrier, protecting it from harmful substances that may be carried in the plasma of the blood. Ependymal cells form the blood–CSF barrier, controlling the substances that are allowed to enter the CSF.
Choroid Plexus Tumors and Meningiomas
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Kenneth K. Wong, Elwira Szychot, Jennifer A. Cotter, Mark Krieger
CPTs are rare central nervous system (CNS) tumors derived from choroid plexus epithelium. The choroid plexus is well-perfused neuroepithelial tissue located mainly in the lateral, third, and fourth ventricles. The choroid plexus has an enormous surface area, approximately 25–50% the size of the inner capillary surface area of the brain.1 The choroid plexus is responsible for secretion of the cerebrospinal fluid (CSF) (generating intracranial pressure), maintaining CSF ion homeostasis, and providing micronutrients, proteins, and hormones for neuronal and glial development.1 The choroid plexus has roles in brain immunity, protection from toxins, and absorption and removal of waste products.2
Decline of stress resilience in aging rats: Focus on choroid plexus-cerebrospinal fluid-hippocampus
Published in The World Journal of Biological Psychiatry, 2023
Kaige Liu, Huizhen Li, Ningxi Zeng, Wenjun Lu, Xiaofeng Wu, Hanfang Xu, Can Yan, Lili Wu
Choroid plexus (CP), a highly vascularised tissue, is the major site of cerebrospinal fluid (CSF) production. Stress and ageing can both result in morphologic changes in CP, including volume reduction, cellular atrophy, microvilli shortening, thickening of the basement membrane, and so on (Kaur et al. 2016; Kratzer et al. 2020). Low expression of receptors and transporters on CP may induce transport dysregulation, and thus affect CSF constituents (Wu et al. 2020). During normal ageing, CSF exhibits reduced production and increased circulation resistance, with downregulated neurotrophins (Lugert et al. 2017). Physiologically, hippocampus is adjacent to the lateral ventricles. CSF composition can act directly on hippocampus, proceeding to changes in hippocampal structure and function, such as regulating neurogenesis, neuronal survival, and synaptic plasticity (Ziegler et al. 2015).
Choroid plexus and CSF: an updated review
Published in British Journal of Neurosurgery, 2022
Dana Hutton, Mohammed Gadoora Fadelalla, Avinash Kumar Kanodia, Kismet Hossain-Ibrahim
The choroid plexus (ChP) is a highly vascularised secretory tissue within the ventricles of the brain. The ChP is responsible for (1) producing an adequate volume of cerebrospinal fluid (CSF) to ‘float’ the brain and spinal cord, (2) forming the blood-CSF barrier (BCSFB), (3) homeostasis of CSF composition, and (4) removal of waste products and metabolites through continuous CSF renewal.1–4 An optimal environment for neurons and glial cells is maintained by the blood-brain barrier (BBB) and the ChP acting as the BCSFB.4–6 An equilibrium of CSF production and absorption is required for the formation and integrity of the central nervous system (CNS). Sufficient CSF production and intracranial pressure is required for normal growth and development; however, an excess of CSF ultimately leads to hydrocephalus.2,6,7
Norrie disease with a spontaneously shrinking choroid plexus abnormality: a case report
Published in Ophthalmic Genetics, 2021
Subhi Talal Younes, James Mason Shiflett, Kristin Weaver, Andrew Smith, Betty Herrington, Charlotte Taylor, Kartik Reddy
As a whole, choroid plexus masses are rare in children, accounting for 1% or less of intracranial tumors in children. The most common choroid plexus lesions in children include choroid plexus cysts, choroid plexus papilloma, or choroid plexus carcinoma. Choroid plexus cysts are believed to arise from fluid trapping within the developing neuroepithelium (12). Estimated to be present in one to 2% of the population, such cysts require no intervention. Choroid plexus papilloma and carcinoma are neoplasms; as such, they require treatment. The former can be cured with surgery alone (13). The latter is typically a manifestation of an underlying cancer predisposition syndrome, most commonly, Li Fraumeni (14). These aggressive tumors require resection and adjuvant therapy, usually craniospinal irradiation or intensive chemotherapy regimens (15,16). Unfortunately, survival for choroid plexus carcinoma remains poor. For reasons explained above, none of these entities appeared to be the diagnosis in this patient.