1. CSF
PRODUCTION,
CIRCULATION
&ABSORPTION
LECTURE
BY
DR. ANSARI
CHAIRPERSON & PROF. OF ANATOMY
RAK COLLEGE OF MEDICAL SCIENCES
&
RAK COLLEGE OF DENTAL SCIENCES
Tuesday, January 07, 2014
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2. A 9 year old boy was brought to his GP by his parents who noted that he
was having difficulty with his balance and was complaining of head
aches.
• He was referred to the neurosurgical unit and a CT scan
was perform of his head region. This showed the
presence of dilated lateral and III ventricles with a normal
IV ventricle. There was effacement of the overlying
cortical sulci in the brain and a diagnosis of
Hydrocephalus was made. MRI showed the cerebral
aqueduct was stenosed.
• The boy subsequently had a III ventriculostomy
performed, and his symptoms resolved rapidly.
Tuesday, January 07, 2014
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3. Tuesday, January 07, 2014
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4. C.S.F Circulation involves
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Lateral ventricle.
III ventricle.
Cerebral aqueduct.
IVventricle.
Subarachnoid cisterns
Subarachnoid spaces
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5. Sub arachnoid cisterns & spaces
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•
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The major cisterns are:1) Cisterna interpeduncularis
2) Cisterna ambiens
3) Cisterna magna
4) Cistern of the lateral sulcus
• 5) Cisterna pontis
• 6) Subarachnoid spaces
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6. Tuesday, January 07, 2014
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7. Tuesday, January 07, 2014
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8. The arachnoid villi & granulations
• Are the structures that drain the excess amount of
CSF into the circulatory system/Dural venous
sinuses.
• These are the safety valve that opens up and drain
into the superior Sagittal sinus.
• From the ventricles the CSF comes out into the
subarachnoid sinuses through 3 apertures,
• Foramen of Magendie & foramina of Lusaka
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9. The CSF is drained in to the superior sagittal sinus through the arachnoid villi and granulations
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10. Humans produce 500 ml of CSF daily
The total CSF volume is only 1/3 of the daily
production.
• Most of the 500 ml of CSF is produced in the
choroid plexuses in the four brain ventricles, and
the remaining is produced across the blood-brain
barrier.
• The CSF passes from the lateral ventricles (I and II)
through the foramen of Monroe into the third
ventricle (III), through the aqueduct of Sylvius, the
fourth ventricle (IV), and out into the subarachnoid
space through the foramina Lushka & Magendie .
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11. (18) foramina of Lushka
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12. Foramen of Monro/interventricular
foramen (12)
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13. Cast of the ventricles of brain
1. Anterior horn of lateral
ventricle
2. Body of lateral ventricle
3. Posterior horn of lateral
ventricle
4. Inferior horn of lateral
ventricle
5. Third ventricle
6. Fourth ventricle
7. Interventricular
foramen
8. Cerebral aqueduct
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14. The lateral ventricles
• Situated in the cerebral hemispheres, it has a
body, an anterior horn in the frontal pole, posterior
horn in the occipital pole &inferior horn in the
temporal pole.
• The two lateral ventricles are interconnected by
interventricular foramen and it also communicates
with the III ventricle.
• All ventricles are lined by ependyma.
• The choroid plexus are formed by a dual layer of
ependyma invaded by bunch of capillaries.
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15. Tuesday, January 07, 2014
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16. Tela choroidea (7) is a double fold of Pia mater entering into
the choroid fissure and forming the organs for CSF formation
along with the choroid plexus
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17. Tela
choroidea
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18. The duct of Sylvius/Cerebral aqueduct
forms the cavity of midbrain
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19. Tuesday, January 07, 2014
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20. Roof of IV ventricle formed by cerebellum and
superior cerebellar peduncles and superior
medullary velum
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21. The fifth ventricle & terminal ventricle
• The central canal expanding at the level of filum
terminale, of conus medullaris, is the terminal
ventricle.
• The fifth ventricle is the median cleft between the
two laminae of the brain's septum pellucidum
(cavum septum pellucidum).
• The CSF is getting emptied / drained into the dural
venous sinuses through the arachnoid villi and
granulations.
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22. Cavum Septum pellucidum
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23. A sagittal section of the brain showing the ventricles
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24. Tuesday, January 07, 2014
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25. III Ventricle
• It lies below the lateral ventricles.
• It is a cavity of the diencephalon. In the roof there is
choroid plexus, that produce CSF.
• Superiorly it communicates with the two lateral
ventricles through the interventricular foramen.
• Inferiorly it communicates with the IV ventricle
through the cerebral aqueduct.
• The lateral wall is formed by thalamus and
hypothalamus. The two thalami are annexed by
interthalamic adhesion.
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26. Structures in the lateral wall of III ventricle
Tuesday, January 07, 2014
1. Thalamus
2. Hypothalamus
3. Midbrain
4. Pons
5. Interthalamic adhesion
6. Anterior commissure
7. Optic chiasma
8. Mammillary body
9. Pineal body
10. Tectum of midbrain
11. Lamina terminalis
12. Interventricular foramen
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27. IV Ventricle
• It is a cavity of the
rhombencephalon.
• It has a roof and floor.
• The floor is formed by two
parts, medullary &
pontine part.
• Hypoglossal nucleus, vagal
nucleus, trigeminal
nucleus, glossopharyngeal
nucleus, auditory nuclei
and facial and abducent
nuclei are located in the
Tuesday, January
floor. 07, 2014
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28. Applied anatomy of ventricles of brain
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Hydrocephalus
Anencephaly
Spina bifida
Meningitis
Encephalitis
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29. Imaging study showing enlarged
cavities of brain due to hydocephalous
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