Cerebrospinal fluid is a clear, watery fluid that surrounds the brain and the

spinal cord. It is an ultra-filtrate of blood plasma and is contained within the

subarachnoid space and the central canal of the spinal cord.
Contents of CSF
  CSF Blood
pH 7.33 7.41
Osmolarity 295 mOsm/L 295 mOsm/L
Glucose (fasting) 2.5 – 4.5 mmol/L 3.0 – 5.0 mmol/L
Protein 200 – 400 mg/L 60 – 80 g/L
Sodium 144 – 152 mmol/L 135 – 145 mmol/L
Potassium 2.0 – 3.0 mmol/L 3.8 – 5.0 mmol/L
Chloride 123 -128 mmol/L 95 – 105 mmol/L
Calcium 1.1 – 1.3 mmol/L 2.2 – 2.6 mmol/L
Urea 2.0 – 7.0 mmol/L 2.5 – 6.5 mmol/L
Flow of CSF
CSF Production

The CSF is produced by the choroid plexus which can be found in the two

lateral ventricles, and in the roof of the third and fourth ventricles. Around 500
ml is produced each day, with around 150-250 ml being present in the body at
any one time.

The choroid plexus is composed of a fenestrated endothelium, a pial layer

and a layer of specialised ependymal cells. The blood plasma is filtered
through the fenestrated endothelial layer, only allowing passage for certain
substances. This is followed by active transport of substances through the
ependymal cells. Some substances get transferred by passive transport and
diffusion of water. This allows osmolarity to be maintained.

CSF is produced continuously which keeps the fluid in circulation around the
central nervous system. The fluid will move from the lateral ventricle to the
third and then to the fourth ventricle. From the fourth ventricle, the fluid moves
out into the subarachnoid space and/or the central canal of the spinal cord
through the two lateral foramina of Luschka and the medial foramen of
Magendie.

CSF Clearance

CSF gets drained into the superior sagittal venous sinus through the
arachnoid villi. The pressure gradient between the subarachnoid space and
the venous sinus results in the fluid moving through the arachnoid villi.

Further information on the anatomy of the ventricles and drainage of CSF can
be found here.

 By TeachMeSeries Ltd (2020)

Fig 1.0 – Overview of the cerebrospinal fluid distribution in the CNS.

Functions of CSF
The CSF has many functions:
 Buoyancy – the brain weighs ~1400g, but due to the presence of CSF
creating a bath, it only has a net weight of 50g. The brain otherwise is only
supported within the arachnoid space by blood vessels and nerve roots which
are fragile structures.
 Protection – CSF acts as a shock absorber preventing damage from
occurring to the brain when the cranium is jolted/hit.
 Homeostasis – regulates the distribution of metabolites surrounding the
brain keeping the environment ideal to prevent any damage to the nervous
system.
 Clearing waste – waste products produced by the brain move into the
CSF which then clears out through the arachnoid granulations into the venous
sinus so it can be absorbed into the bloodstream.