Cerebrospinal fluid
The liquid cerebrospinal (LCS) or even liquid cerebrospinal fluid (CSF) is a transparent body fluid in which bathe the brain and spinal cord. It is contained in the meninges, specifically between the PIAL (which covers the central nervous system) and the arachnoid (lining of the inner slope of the dura mater). It is also the liquid flowing in the four cerebral ventricles in the brain, and in the central canal of the spinal cord.
Cerebrospinal fluid absorbs and dampens the movements or shocks that could damage the brain. He is also the liquid in which the molecules and “waste” from the brain are evacuated and also plays a role of immunologic protection. Its composition is thus supposed to reflect the pathophysiologic State of the brain (inflammation, infection, presence of pharmacological molecules, etc.).
Production and resorption
The LCS is synthesized at the level of the choroid plexus, highly vascularized structures that hang from the roof of the cerebral ventricles. For example, ventricular V4, is formed by a Medullary veil upper and lower presents a lower choroidal canvas where the LCS is secreted. The secretion of the LCS by ventricular V4 is very minority, it being mainly in the lateral ventricles of the telencephalon [REF. necessary].
The LCS circulates freely in the ventricular system and meninges, through a continuous circuit and is not isolated pocket of liquid in stagnation.
The LCS is resorbed by the cerebral venous system to the level of arachnoïdiennes villi.
Characteristics
Its volume in adult humans is of about 150 mL. The production of the LCs is the order of 500-1200 mL/day. Every day, the LCS is renewed between 3 and 4 times on the average, or every 6 to 8 hours.
Normal pressure of the LCS (topic in the supine, i.e. lying on the back) is 5 to 10 mm Hg [REF. necessary]. If something (like a tumour) is a bar to his drainage, the LCS accumulates in the ventricles. Greater than 15 mm Hg pressure reflects intracranial hypertension (HTIC) [REF. necessary]. It is called hydrocephalus. In infants, hydrocephalus causes an increase in the volume of the head, while in adults, the LCS causes pressure on the hemispheres and leads instead of brain.
Average composition
The LCS consists of: [REF. necessary]
- water: 99%
- protein (protéinorachie): < 0.40 g/l
- glucose (glycorachie) = 0.5 g/l must be equal to 1/2 the sugar
- Chlorides (chlorurorachie) = 115 mEq/l
Roles
The main roles of the LCS are:
- mechanical protection of the central nervous system against shock by amortization of movements and relief of 97% of its weight;
- protection against infections, because it contains the mediators of humoral and cellular immunity [REF. necessary];
- the transport of nutrients and hormones. However, the CRL contains little protein, sugars and mineral salts.
Sampling and diagnosis
The collection of a few of cerebrospinal fluid is in a medical procedure called lumbar puncture in the lower back, between the 4th and 5th lumbar vertebrae. Lance lumbar often leads to headaches because of changes to the pressure on the brain.
Lumbar puncture to diagnose several neurological pathologies. The collection of the LCS by lumbar puncture to confirm the presence of acute meningitis, encephalitis or subarachnoid hemorrhage, when they are suspected. The analysis of the LCS can be bacteriological, cytological (cells analysis) or chemical [REF. necessary].
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