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Review
. 2018 Nov 26:2018:2928378.
doi: 10.1155/2018/2928378. eCollection 2018.

Controversies and Misconceptions Related to Cerebrospinal Fluid Circulation: A Review of the Literature from the Historical Pioneers' Theories to Current Models

Giorgio Mantovani  1 , Marta Menegatti  1 , Alba Scerrati  2 , Michele Alessandro Cavallo  2 , Pasquale De Bonis  2
Affiliations
Review

Controversies and Misconceptions Related to Cerebrospinal Fluid Circulation: A Review of the Literature from the Historical Pioneers' Theories to Current Models

Giorgio Mantovani et al. Biomed Res Int. .

Abstract

Models of cerebrospinal fluid (CSF) circulation have been mainly proposed in the last century: CSF goes from the ventricles to the subarachnoidal space (SAS), passing through the aqueduct and the foramen of Luschka and Magendie. Indeed, new models, involving the Virchow-Robin space (VRS) and the perivascular space (PVS), have been proposed. We critically reviewed the literature, in order to clarify the "classical" errors and to discuss the "new" models that are evolving currently. Conclusions of past experiments are often not justified, due to lack of reproducibility and methodological issues. On the other hand, investigation on the microanatomy of Virchow-Robin spaces (VRS) and several new experiments showed a potential pathway for a more complex CSF "circulation," with chaotic and unpredictable flows. It seems reasonable to elaborate a new model of CSF physiology, including new findings and questioning old certainties. However, proved data are still missing and it is hazardous to come to final conclusions. More studies are needed.

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Figures

Figure 1
Figure 1
Evidences supporting the classic model of CSF circulation.
Figure 2
Figure 2
Cushing's model of CSF circulation [13].
Figure 3
Figure 3
Evidences supporting (red) and confuting (green) the classic model of CSF circulation.
Figure 4
Figure 4
The “new” fluid balance model. IF: interstitial fluid; PVS: perivascular space; SAS: subarachnoid space.
See this image and copyright information in PMC

References

    1. Cotugno D. De Ischiade Nervosa Commentarius. Napoli, Italy: Apud Fratres Simonios; 1764.
    1. Magendie F. Memoire sur le liquide qui se trouve dans le crane et l’épine de l’homme et des animaux. Journal de Physiologie Expérimentale et Pathologique. 1825;5:27–37.
    1. Weed L. H. Studies on cerebro-spinal fluid. No., II, the theories of drainage of cerebro-spinal fluid with an analysis of the methods of investigation. The Journal of Medical Research. 1914;31, article 21 - PMC - PubMed
    1. Dandy W. E., Blackfan K. D. An experimental and clinical study of internal hydrocephalus. Journal of the American Medical Association. 1913;61(25):2216–2217. doi: 10.1001/jama.1913.04350260014006. - DOI
    1. Frazier C. H., Peet M. M. Factors of influence in the origin and circulation of the cerebrospinal fluid. American Journal of Physiology-Legacy Content. 1914;35(3):268–282. doi: 10.1152/ajplegacy.1914.35.3.268. - DOI