Cerebrospinal Fluid and its Abnormalities

Cerebrospinal fluid bathes the central nervous system, providing mechanical support and maintaining a stable environment. Alterations in its production, circulation or absorption result in a pathological condition termed hydrocephalus, characterized by an accumulation of fluid within the cranium, usually in the ventricles of the brain. Similarly, aberrations in the circulation or absorption of cerebrospinal fluid around the spinal cord can create a condition termed syringomyelia. Hydrocephalus can be life-threatening due to increased intracranial pressure. The most common causes of hydrocephalus are related to obstruction of cerebrospinal fluid flow. In the pediatric population, causes of hydrocephalus include developmental abnormalities, infectious aetiologies, mass lesions, and haemorrhage. Causes of high pressure hydrocephalus in adulthood are primarily related to haemorrhage and tumour, although idiopathic normal pressure hydrocephalus (NPH) is also encountered. The management of hydrocephalus and syringomyelia relies primarily on neurosurgical interventions such as insertion of shunt devices. Key ConceptsKey Concepts * CSF provides a mechanical support for the brain and spinal cord. * Overproduction of CSF, obstruction to CSF flow or impaired absorption of CSF may lead to disease states such as hydrocephalus or syringomyelia. * CSF diversion by means of shunting with catheter implantation or fenestration of anatomic barriers is the primary treatment for diseases of CSF disturbances.