Cerebrospinal fluid


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cerebrospinal

 [ser″ĕ-bro-spi´nal]
pertaining to the brain and spinal cord.
cerebrospinal fluid the fluid within the subarachnoid space, the central canal of the spinal cord, and the four ventricles of the brain. The fluid is formed continuously by the choroid plexus in the ventricles, and, so that there will not be an abnormal increase in amount and pressure, it is reabsorbed into the blood by the arachnoid villi at approximately the same rate at which it is produced.

The cerebrospinal fluid aids in the protection of the brain, spinal cord, and meninges by acting as a watery cushion surrounding them to absorb the shocks to which they are exposed. There is a blood-cerebrospinal fluid barrier that prevents harmful substances, such as metal poisons, some pathogenic organisms, and certain drugs from passing from the capillaries into the cerebrospinal fluid.

The normal cerebrospinal fluid pressure is 5 mm Hg (100 mm H2O) when the individual is lying in a horizontal position on his side. Fluid pressure may be increased by a brain tumor or by hemorrhage or infection in the cranium. hydrocephalus, or excess fluid in the cranial cavity, can result from either excessive formation or poor absorption of cerebrospinal fluid. Blockage of the flow of fluid in the spinal canal may result from a tumor, blood clot, or severance of the spinal cord. The pressure remains normal or decreases below the point of obstruction but increases above that point.

Cell counts, bacterial smears, and cultures of samples of cerebrospinal fluid are done when an inflammatory process or infection of the meninges is suspected. Since the cerebrospinal fluid contains nutrient substances such as glucose, proteins, and sodium chloride, and also some waste products such as urea, it is believed to play a role in metabolism. The major constituents of cerebrospinal fluid are water, glucose, sodium chloride, and protein. Information about changes in their concentrations is helpful in diagnosis of brain diseases.

Samples of cerebrospinal fluid may be obtained by lumbar puncture, in which a hollow needle is inserted between two lumbar vertebrae (below the lower end of the spinal cord), or into the cisterna cerebellomedullaris just below the occipital bone of the skull (cisternal puncture). Pressure of the cerebrospinal fluid is measured by a manometer attached to the end of the needle after it has been inserted.

cer·e·bro·spi·nal flu·id (CSF),

[TA]
a fluid largely secreted by the choroid plexuses of the ventricles of the brain, filling the ventricles and the subarachnoid cavities of the brain and spinal cord.
Synonym(s): liquor cerebrospinalis [TA]

cerebrospinal fluid

n.
The serumlike fluid that circulates through the ventricles of the brain, the cavity of the spinal cord, and the subarachnoid space, functioning in shock absorption. Also called spinal fluid.

cerebrospinal fluid

Spinal fluid Neurology A clear, colorless fluid that contains small quantities of glucose and protein, which surrounds the brain, spinal cord, ventricles, subarachnoid space, and the central canal of the spinal cord, provides nutrients, and acts as a shock absorber; CSF analysis is accomplished by lumbar puncture; WBCs or bacteria in the CSF indicate bacterial–septic meningitis. See Lumbar puncture.

cer·e·bro·spi·nal flu·id

(CSF) (ser'ĕ-brō-spī'năl flū'id) [TA]
A fluid largely secreted by the choroid plexuses of the ventricles of the brain, filling the ventricles and the subarachnoid cavities of the brain and spinal cord.
Enlarge picture
FLOW OF CEREBROSPINAL FLUID THROUGH THE BRAIN AND SPINAL COLUMN: Formation, circulation, and reabsorption of CSF

cerebrospinal fluid

Abbreviation: CSF
The sodium-rich, potassium-poor tissue fluid of the brain and spinal cord. The fluid supplies nutrients and removes waste products; it is also a watery cushion that absorbs mechanical shock to the central nervous system. Synonym: spinal fluid See: lumbar puncture

Formation

The fluid is formed by the choroid plexuses of the lateral and third ventricles. That of the lateral ventricles passes through the foramen of Monro to the third ventricle, and through the aqueduct of Sylvius to the fourth ventricle. There it may escape through the central foramen of Magendie or the lateral foramina of Luschke into the cisterna magna and to the cranial and spinal subarachnoid spaces. It is reabsorbed through the arachnoid villi into the blood in the cranial venous sinuses, and through the perineural lymph spaces of both the brain and the cord. See: illustration

Characteristics

The fluid is normally watery, clear, colorless, and almost entirely free of cells. The initial pressure of spinal fluid in a side-lying adult is about 100 to 180 mm of water. On average, the total protein is about 15 to 50 mg/dL, and the concentration of glucose is about twothirds the concentration of glucose in the patient's serum. Its pH, which is rarely measured clinically, is slightly more acidic than the pH of blood. Its concentration and alkaline reserve are similar to those of blood. It does not clot on standing. Turbidity suggests an excessively high number of cells in the fluid, typically white blood cells in infections such as meningitis or red blood cells in intracerebral hemorrhage.

CSF may appear red following a recent subarachnoid hemorrhage or when the lumbar puncture that obtained the CSF caused traumatic injury to the dura that surround the fluid. Centrifugation of the fluid can distinguish between these two sources of blood in the spinal fluid: the supernatant is usually stained yellow (xanthochromic) only when there has been a recent subarachnoid hemorrhage.

Many conditions may cause increases in CSF total protein: infections, such as acute or chronic meningitis; multiple sclerosis (when oligoclonal protein bands are present); Guillain-Barré syndrome; and chronic medical conditions like cirrhosis and hypothyroidism (when diffuse hypergammaglobulinemia is present). The concentration of glucose in the CSF rises in uncontrolled diabetes mellitus and drops precipitously in meningitis, sarcoidosis, and some other illnesses. Malignant cells in the CSF, demonstrated after centrifugation or filtering, are hallmarks of carcinomatous meningitis.

Microorganisms

The CSF is normally sterile. Meningococci, streptococci, Haemophilus influenzae, Listeria monocytogenes, and gram-negative bacilli are recovered from the CSF only in cases of meningitis. Syphilitic meningitis is usually diagnosed with serological tests for the disease, such as the venereal disease research laboratory (VDRL) test, the rapid plasma reagin (RPR) test, or the fluorescent treponemal antibody test. Cryptococcal infection of the CSF may be demonstrated by India ink preparations, or by latex agglutination tests. Tuberculous meningitis may sometimes be diagnosed with Ziehl-Neelsen stains, but more often this is done with cultures. These last three infections (syphilis, cryptococcosis, and tuberculosis) are much more common in patients who have acquired immunodeficiency syndrome (AIDS) than in the general population.

illustration
See also: fluid

cerebrospinal fluid

The watery fluid that bathes the brain and spinal cord and also circulates within the ventricles of the brain and the central canal of the cord.

cerebrospinal fluid (CSF)

a solution secreted by the CHOROID PLEXUSES (one in the roof of each of the four brain VENTRICLES (2) in man) which fills the cavity of the brain and SPINAL CORD and the space between the CENTRAL NERVOUS SYSTEM and its ensheathing membrane. It contains most of the small molecules found in blood, e.g. salts and glucose, but little protein and few cells, and serves as a nutritive medium. In humans the total volume is about 100 cm3.

Cerebrospinal fluid (CSF)

Fluid produced within the brain for nutrient transport and structural purposes. CSF circulates through the ventricles, open spaces within the brain, and drains through the membranes surrounding the brain.

cer·e·bro·spi·nal flu·id

(CSF) (ser'ĕ-brō-spī'năl flū'id) [TA]
A fluid largely secreted by the choroid plexuses of the ventricles of the brain, filling the ventricles and the subarachnoid cavities of the brain and spinal cord.
References in periodicals archive ?
A hospital based study on estimation of adenosine deaminase activity (ADA) in cerebrospinal fluid (CSF) in various types of meningitis.
Diagnosis and treatment of cerebrospinal fluid rhinorrhea following accidental traumatic anterior skull base fractures.
Shinohara et al., "Spinal cerebrospinal fluid leaks detected by radionuclide cisternography and magnetic resonance imaging in patients suspected of intracranial hypotension," Advances in Medical Sciences, vol.
The examination results of LDH, CK and LA between the two groups: The examination results of the cerebrospinal fluid demonstrated that, the LDH concentration of the tubercular meningitis group was the highest, the CK concentration of the purulent meningitis group was the highest, and the LA concentration of the tubercular meningitis group and purulent meningitis group was higher than the other two groups.
Prevention and management of cerebrospinal fluid leak following vestibular schwannoma surgery.
Hammerschlag, "Cerebrospinal fluid rhinorrhea and recurrent meningitis," Clinical Infectious Diseases, vol.
Our patient showed many of the classic signs and symptoms of meningeal TB, including a history of headache, worsening altered mental status, and abnormal cerebrospinal fluid protein and glucose values.
Leal-Hernandez, "Cerebrospinal fluid blepharocele: An unusual complication of head injuries," Neurosurgery, vol.
We carried out assessment using scales and alumbar puncture to collect the patients' cerebrospinal fluid at baseline and after 6 months.
[20.] Polk DB, Steele RW Bacterial meningitis presenting with normal cerebrospinal fluid. Pediatr Infect Dis J 1987;6(11):1040-1042.
Visit the Cerebrospinal Fluid Management Market - Global Patient Solutions, System Strengthening and End Users Analysis and Forecast 2013-2020 report at http://www.ihealthcareanalyst.com/report/cerebrospinal-fluid-management-market/
Employing an animal model, Helen Benveniste and colleagues from Stony Brook University (New York, US) studied the cerebrospinal fluid (CSF)--interstitial fluid (ISF) exchange efficiency --a marker of the clearance capacity of the glymphatic pathway.

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