Cerebrospinal Fluid (CSF): Composition, Circulation and

Function
1. Composition of CSF 2. Circulation of CSF 3. Functions.

Composition of CSF:
1. Clear, colorless, transparent fluid

2. Alkaline in nature

3. Around 0.3 ml of CSF is produced/min

4. Specific gravity 1.005

5. Water99.13%

6. Solids0.87 %

7. K+ = 3.00 mEq, whereas plasma has 5.0 mEq

8. CI = 114.0 mEq whereas plasma has 100 mEq
9. Glucose: 60 mg% whereas plasma has 60-90 mg%

10. Proteins: 20 mg% whereas plasma has 6-8 gm%

In brain, there are four ventricles. They are two lateral ventricles (one each in
cerebral hemispheres) and third and fourth ventricles. Choroid plexuses present
more abundantly in lateral ventricles than in 3rd or 4th ventricles. These choroid
plexuses (capillary network) are main source of formation of CSF.

CSF is formed by two different processes, namely active secretion and

ultrafiltration:
a. Active secretion is brought about by choroid plexus.

b. Ultrafiltration or dialysis is brought about by blood vessels that are present in

ventricular regions
Circulation of CSF:
i. From lateral ventricles, CSF reaches 3rd ventricle through foramina of
Monroe.

ii. From 3rd ventricle to 4th ventricle, it reaches through cerebral aqueduct or
aqueduct of Sylvius.

iii. From 4th ventricle, it reachesspinal canal through foramen of Magendie and
into subarachnoid spaces throughout CNS through foramina of Luschka.

CSF formed gets absorbed after its function is over. Most of CSF gets absorbed
into arachnoid villi and granulations which dip into subdural venous sinuses.

Subarachnoid spaces can be reached either by lumbar or cisternal puncture.

Lumbar puncture is preferred because cisternal puncture requires insertion of
needle into subarachnoid spaces near brainstem region. In the process, there are
chances of brainstem neurons getting damaged. It is much easier to perform
lumbar puncture to get a sample of CSF for diagnostic purposes.

Significance of Lumber puncture:

i. To obtain a sample of CSF for chemical, physical and histological
examination.

ii. Measure intracranial tension and if intracranial tension has increased, some
amount of CSF can be removed to decrease tension. However, while relieving
raised intracranial tension by lumbar puncture; there are chances of herniation
of brain. This should be borne in mind before lumbar puncture is desired to
relieve raised intracranial tension.

iii. To inject antibiotics that cannot pass through blood brain barrier.

iv. To induce spinal anesthesia.

Functions of CSF:
1. CSF provides buoyancy effect to brain. Normal weight of brain is about 1500
gm. Because of buoyancy effect provided by CSF, the effective weight of brain
is reduced to about 50 gm. This facilitates maneuverability of head over neck
region.

Weight of brain acts on lumbar region because CSF extends into spinal cord
along the course of vertebral column. From vertebral column, it gets radiated to
ground along support legs provide to body. So the person would feel 50 gm out
of total weight of 1500 gm. Total weight does not decrease only effective
weight borne by head is reduced by almost 30 times.

2. Acts as an effective interstitial fluid so that exchange of substances can take

place between blood and brain tissues.

3. Interstitium of brain (microenvironment in brain) is maintained so that

excitability of neuronal tissue is achieved and properly maintained.

4. Acts as shock absorber: Prevent damage to neuron in CNS because any

damage to neurons in CNS is almost irreparable. When there is any impact on
cranium, since brain is suspended in fluid environment of CSF, CSF acts as
water cushion. The impact on head is dissipated to wider area and thereby direct
impact on underlying brain tissue is minimized.

5. Tries to maintain contents of intracranial cavity as constant (relative volume

of blood, neuronal tissue and CSF). Cranial vault is made of bony structures and
hence cranial cavity volume is fixed. In this fixed volume, neuronal tissue,
blood and CSF are present. If there is an increase or decrease in volume of
either neuronal tissue or blood, corresponding changes in volume occupied by
CSF is brought about.

Blood-Brain Barrier:
When trephan blue (an acidic dye) is injected into blood all tissues of body get
stained except for certain regions in brain tissue. There is a barrier preventing
diffusion of dye from blood into brain tissues and this barrier is known as
blood-brain barrier.

a. Present in CNS.

b. Provides protection to maintain constant internal environment in CNS.

c. Tight junctions at adjacent endothelial cells of brain capillaries contribute for
formation of blood-brain barrier.

d. In addition to this, foot process of astrocytes reinforces this barrier.

e. Some of regions of CNS which are devoid of this barrier are (hypothalamus
region):

i. Posterior pituitary

ii. Area postrema

iii. Organum vasculosum of lamina terminals

iv. Subfornical organ

Area postrema, organum vasculosum of lamina terminalis and subfornical organ

are together called as circumventricular organs.

In newborn infants, blood-brain barrier is not completely developed. It is

developed completely only after birth. In about 1 to 2 years of life, it is
developed completely.

Hence during postpartum jaundice (neonatal), bilirubin can get deposited on

neurons in basal ganglia resulting in kernicterus.

Knowledge of blood-brain barrier is important for doctors because while

administering certain drugs they should know whether the drug has ability to
cross the barrier to reach neurons in CNS in order to bring about actions.

Hydrocephalus is a condition in which there will be abnormal accumulation of

CSF in skull leading to enlargement of head.

Internal/non-communicating hydrocephalus is where one of foramina for

passage of CSF into ventricles is blocked. This leads to dilation of ventricle.

When subarachnoid villi are blocked, it is known as communicating or external

hydrocephalus. This can lead to atrophy of brain, mental weakness and
convulsions.