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Abstract:

‘The traditional model of cerebrospinal fluid (CSF) hydrodynamics is being increasingly challenged in view of recent scientific evidences. The established model presumes that CSF is primarily produced in the choroid plexuses (CP), then flows from the ventricles to the subarachnoid spaces, and is mainly reabsorbed into arachnoid villi (AV). This model is seemingly based on faulty research and misinterpretations. This literature review presents numerous evidence for a new hypothesis of CSF physiology, namely, CSF is produced and reabsorbed throughout the entire CSF-Interstitial fluid (IF) functional unit. IF and CSF are mainly formed and reabsorbed across the walls of CNS blood capillaries. CP, AV and lymphatics become minor sites for CSF hydrodynamics. The lymphatics may play a more significant role in CSF absorption when CSF-IF pressure increases. The consequences of this complete reformulation of CSF hydrodynamics may influence applications in research, publications, including osteopathic manual treatments.’

http://www.bodyworkmovementtherapies.com/article/S1360-8592(13)00010-7/abstract

Chikly, B., Quaghebeur, J., Reassessing cerebrospinal fluid (CSF) hydrodynamics: A literature review presenting a novel hypothesis for CSF physiology, Journal of Bodywork & Movement Therapies (2013), http://dx.doi.org/10.1016/ j.jbmt.2013.02.002

(only the abstract is available here I am afraid)

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Massive ventricular enlargement, in a patient with normal social functioning(A) CT; (B, C) T1-weighted MRI, with gadolinium contrast; (D) T2-weighted MRI. LV=lateral ventricle. III=third ventricle. IV=fourth ventricle. Arrow=Magendie's foramen. The posterior fossa cyst is outlined in (D).

Massive ventricular enlargement, in a patient with normal social functioning
(A) CT; (B, C) T1-weighted MRI, with gadolinium contrast; (D) T2-weighted MRI. LV=lateral ventricle. III=third ventricle. IV=fourth ventricle. Arrow=Magendie’s foramen. The posterior fossa cyst is outlined in (D).

From article in The Lancet 2007 titled ‘Brain of a white-collar worker’

A 44 year old man presented to the doctor with a weakness in his leg. ‘His neurological development and medical history were otherwise normal. He was a married father of two children, and worked as a civil servant.’ On CT scan they found an incredible brain that is mostly ventricles.

Wild, how does that work?

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)61127-1/fulltext

Amazing footage of an operation to repair a cerebrospinal fluid [CSF] leak. In some patients, the CSF may start leaking spontaneously. This type of leakage occurs into the ear or the sinuses. In this surgical video, you will see the repair of a spontaneous CSF leakage that originated in the posterior fossa. This surgery is performed by Dr. Hamid R. Djalilian, director of otology, neurotology, and skull base surgery. Notice the introduction of fascia and bone wax to help seal the leakage.

http://youtu.be/2HjSTAB6dqM

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