Cerebrospinal fluid (CSF) is produced mainly by the choroid plexus which is a structure lining the floor of the lateral ventricle and the roof of the third and fourth ventricles.
Chorid plexus in the developing human brain (Stage 22)
In development and the space within the spinal cord (central canal) and the brain (ventricles) was derived from the same space within the neural tube. In the adult these 2 spaces remain connected containing the same CSF.
Early in development the cavity within the neural tube (which will form the ventricular space) is filled with amniotic fluid. As the brain and spinal cord grow, this fluid filled space makes up the majority of the nervous system (by volume). Upon closure of the neuropores and development of the embryonic vasculature, this fluid is then synthesized by the choroid plexus, a specialized vascular epithelium. In mammals, the choroid plexuses develop at four sites in the roof of the neural tube shortly after its closure, in the order forth (IV, lateral, and third (III) ventricles.
Choroid Plexus in lateral ventricle (Week 10 fetus)
The choroid plexuses form one region of the blood-brain barrier that regulates the brain's internal environment.
In adult humans, the total production of CSF is about 400-600 millilitres of fluid a day. This is more than 4 times the overall fluid spaces of the nervous system. Note that some additional fluid also arises from leaking of fluid by the brain into the ventricles.
CSF contains high amount of: salts, sugars and lipids. The total amount of protein in normal CSF is relatively low (0.3-0.7 microg/microL), though there appears to be 60+ proteins as identified by 2D gel. Presence of some protein in the CSF can be indicative of disruption of or incomplete blood/brain barrier.
Page Links: Introduction | Some Recent Findings | Development Overview | Stage 22 Embryo | CSF Production | CSF Synthesis | Alpha-fetoprotein | Adult CSF Normal Values | CSF Circulation | CSF Abnormalities | References | Glossary | Terms
Heep A, Bartmann P, Stoffel-Wagner B, Bos A, Hoving E, Brouwer O, Teelken A, Schaller C, Sival D. Cerebrospinal fluid obstruction and malabsorption in human neonatal hydrocephaly. Childs Nerv Syst. 2006 Oct;22(10):1249-55.
"In neonatal posthaemorrhagic high-pressure hydrocephalus (HC), high concentrations of malabsorption-related biomarkers contrast with lower concentrations in spina bifida and non-haemorrhagic triventricular HC. During the early development of high pressure HC in spina bifida neonates, CSF biomarkers strongly indicate that CSF obstruction contributes more to the development of HC than malabsorption."
Patelska-Banaszewska M, Wozniak W. The subarachnoid space develops early in the human embryonic period. Folia Morphol (Warsz). 2005 Aug;64(3):212-6.
Ventricles and Central Canal
22 days - neural groove begins to close to form the neural tube which remains open to the amniotic space at either end at the neuropores (cranial and caudal). The neural tube space is therefore initially filled with amniotic fluid.
24 days - cranial neuropore closes.
26 days - caudal neuropore closes.
Week 4 - neural tube space will generate both the ventricular space within the brain and the central canal of the spinal cord.
Choroid Plexus Development
Epithelium from the neural tube epithelium.
Mesenchyma from the meninges.
Enzymes required for CSF production are Na+/K+ ATPase and carbonic anhydrase.
Subarachnoid Space Development
Stage 14 (33 days) - initially as irregular spaces on the ventral surface of the spinal cord.
Stage 18 (44 days) - dura mater is formed and spaces surround the circumference of the spinal cord, which coalesce and contain many blood vessels.
(Data from: Patelska-Banaszewska M, Wozniak W., 2005)
There are also several good research articles and reviews from the 1980's and 1990's on CSF development.
Reviews:
Catala M. Embryonic and fetal development of structures associated with the cerebro-spinal fluid in man and other species. Part I: The ventricular system, meninges and choroid plexuses. Arch Anat Cytol Pathol. 1998;46(3):153-69.
Osaka K, Handa H, Matsumoto S, Yasuda M Development of the cerebrospinal fluid pathway in the normal and abnormal human embryos. Childs Brain. 1980;6(1):26-38.
Articles:
O'Rahilly R, Muller F. Ventricular system and choroid plexuses of the human brain during the embryonic period proper. Am J Anat. 1990 Dec;189(4):285-302.
Osaka K, Handa H, Matsumoto S, Yasuda M Development of the cerebrospinal fluid pathway in the normal and abnormal human embryos. Childs Brain. 1980;6(1):26-38.

Head Stage 22- blue box (lower right) shown in image below
Chorid plexus in the Stage 22 Human Brain
Chorid plexus
See also: A section of Stage 22 human head, and a high power image of choroid plexus from this same section.
Cerebrospinal fluid (CSF) is produced by both choroid plexus (a structure lining the floor of the lateral ventricle (ventricle=the brain's interior fluid spaces) and the roof of the third and fourth ventricles) and weeping of tissue fluid by the brain into the ventricles. These structures are capable of producing 400-600 cc's of fluid a day which is enough to completely fill the fluid spaces of the nervous system 4 times over.
Once produced, the CSF circulates from these ventricles to the subarachoid fluid space (a fluid space investing the brain and spinal cord) outside the brain. The CSF then reaches structures (arachoidal villi) along the superior, midline surface of the brain where it is reabsorbed back into the bloodvessels (the sagital sinus). There are several key passage ways through which the CSF must past to exit the ventricular spaces to reach the subarachnoid spaces. First, each of the two lateral ventricles have an outlet into the third ventricle called the foramen of Monroe. The third ventricle in turn has an outlet, the aqueduct of Sylvius or aqueduct, to the fourth ventricle. Finally, the fourth ventricle has three outlets, the foramen of Magendie and the paired foramena of Luschka. Additionally, the subarachnoid space has a potential point for blockage of flow of CSF to the arachnoidal villi at an opening in the tent like structure which divides the upper and lower parts of the brain (the tentorial notch). Distortion or enlargement of the brain in the region of this opening can compress the subarachnoid space preventing fluid from flowing up to the arachnoidal villi.
(text from: CSF Production and Hydrocephalus Institute for Neurology and Neurosurgery at the Beth Israel Nedical Center New York)
Two key enzymes are required to produce CSF they are the Na+/K+ ATPase and carbonic anhydrase.
Other known chorid plexus enzymes include: alkaline and acid phosphatases, magnesium-dependent ATPase, glucose-6-phosphatase, thiamine pyrophosphatase, adenylate cyclase, oxidoreductase, esterases, hydrolases, cathepsin D, and glutathion S-transferase. (More? Catala M., 1998)
"The epithelial cells of the choroid plexus secrete cerebrospinal fluid (CSF), by a process that involves the movement of Na(+), Cl(-) and HCO(3)(-) from the blood to the ventricles of the brain. This creates the osmotic gradient, which drives the secretion of H(2)O. The unidirectional movement of the ions is achieved due to the polarity of the epithelium, i.e., the ion transport proteins in the blood-facing (basolateral) are different to those in the ventricular (apical) membranes."
(text from: Speake T, Whitwell C, Kajita H, Majid A, Brown PD. Mechanisms of CSF secretion by the choroid plexus. Microsc Res Tech. 2001 Jan 1;52(1):49-59. Review.)
Arachnoid Granulation (image: Gray's Anatomy)
CSF drainage (absorption or reabsorption) into the venous system is through arachnoid granulations.
CSF in the subarachnoid space extends into the arachnoid granulations, which then project through the dura into the superior sagittal sinus.
See also note in CSF Circulation section, point 3.
"AFP is produced by both the yolk sack and fetal liver. At around 12 weeks of gestation, the yolk sack degenerates and the fetal liver becomes the main site of AFP synthesis. Concentration of this protein in the fetus is very high (1-10 mg/ml), but it decreases abruptly soon after the birth (by the end of second month postpartum, only a trace amount of AFP can be detected), and it is almost completely substituted by serum albumin. It has been also established that variation in the AFP content during pregnancy can be of use for the detection of fetal abnormalities, including Down's syndrome and open neural tube, defects, such as spina bifida."
(text from:GillespieJR, Uversky VN. Structure and function of alpha-fetoprotein: a biophysical overview. Biochim Biophys Acta. 2000 Jul 14;1480(1-2):41-56.)
Opening pressure: 50–200 mm H2O CSF
Color: Colorless
Turbidity: Crystal clear
Mononuclear cells: less than 5 / mm3
Polymorphonuclear leukocytes: 0
Total protein: 22–38 mg/dl Range 9–58 mg/dl (mean ± 2.0 SD)
Glucose: 60–80% of blood glucose
(Data from: Clinical Methods, 3rd ed, Table 74.1)
Greitz D. Cerebrospinal fluid circulation and associated intracranial dynamics. A radiologic investigation using MR imaging and radionuclide cisternography. Acta Radiol Suppl. 1993;386:1-23. (modified text below from this reference abstract)
Hydrocephalus
Hydrocephalus is the result of an imbalance between the rate at which the CSF is being formed and the rate at which the CSF is passing through the arachnoidal villi back into the blood (hydrocephalus rate is a function of the degree of imbalance in these two).
very small imbalance exhibit subtle, if any, symptoms.
large imbalances will have rapidly evolving symptoms of unmistakable import.
Obstructive Hydrocephalus
Obstruction of the CSF pathways within the interior of the brain or at the tentorial notch (the opening in the tentorium cerebelli fold of dura mater for the brainstem).
Tentorium cerebelli, viewed from above (image: Gray's Anatomy)
Communication Hydrocephalus
Inability of the CSF to pass through the arachnoidal villi to get back into the blood stream. This can result when the arachnoidal villi become inflamed by infection or blood with the inflammatory process blocking the microscopic pores through which the CSF must pass from the subarachoidal space into the blood.
Congenital Hydrocephalus
Present at birth and can be due to blockage at the aqueduct (aqueductal stenosis), congenital anomalies such as an Chiari malformation or Dandy-Walker malformation (malformations at the base of the brain resulting in obstruction of outflow of CSF from the brain's interior) or it can be due to an inflammatory process when premature birth has resulted in bleeding within the brain.
Acquired Hydrocephalus - arises later in postnatal life.
(text modified from: CSF Production and Hydrocephalus Institute for Neurology and Neurosurgery at the Beth Israel Nedical Center New York)
Hydrocephalus - treated by endoscopic third vetriculostomy (ETV) surgery.
Neoplasms
Represents about 0.4 - 0.6% of all intracranial, 2 - 3% of pediatric neoplasms.
Plexus papillomas outnumber choroid plexus carcinomas (by a ratio of 5:1). Choroid plexus carcinomas 80% arise in children.
Plexus tumors are most common in the lateral (80% of lateral ventricle tumors in children) and fourth ventricles (evenly distributed all age groups). (More? text modified from: Rickert )
Links: Journals | Online Textbooks | Search Textbooks | PubMed | Search PubMed | Glossary
Cerebrospinal Fluid Research ISSN: 17438454 Papers on all aspects of cerebrospinal fluid in health and disease.
Clinical Methods Third Edition Walker, H.K.; Hall, W.D.; Hurst, J.W.; editors Stoneham (MA): Butterworth Publishers; c1990 Cerebrospinal Fluid
Neuroscience Purves, Dale; Augustine, George.J.; Fitzpatrick, David; Katz, Lawrence.C.; LaMantia, Anthony-Samuel.; McNamara, James.O.; Williams, S. Mark, editors. Sunderland (MA): Sinauer Associates, Inc. c2001. The Ventricular System
Basic Neurochemistry, Molecular, Cellular, and Medical Aspects 6th ed. Siegal, George J.; Agranoff, Bernard W.; Albers, R. Wayne; Fisher, Stephen K.; Uhler, Michael D., editors. Philadelphia: Lippincott, Williams & Wilkins; c1999.ale; Augustine, George.J.; Fitzpatrick, David; Katz, Lawrence.C.; LaMantia, Anthony-Samuel.; McNamara, James.O.; Williams, S. Mark, editors. Sunderland (MA): Sinauer Associates, Inc. c2001. Blood—Cerebrospinal Fluid Barrier
Reviews
Beni-Adani L, Biani N, Ben-Sirah L, Constantini S. The occurrence of obstructive vs absorptive hydrocephalus in newborns and infants: relevance to treatment choices. Childs Nerv Syst. 2006 Dec;22(12):1543-63.
Oi S, Di Rocco C. Proposal of "evolution theory in cerebrospinal fluid dynamics" and minor pathway hydrocephalus in developing immature brain. Childs Nerv Syst. 2006 Jul;22(7):662-9.
<Catala M. Embryonic and fetal development of structures associated with the cerebro-spinal fluid in man and other species. Part I: The ventricular system, meninges and choroid plexuses. Arch Anat Cytol Pathol. 1998;46(3):153-69.
Osaka K, Handa H, Matsumoto S, Yasuda M Development of the cerebrospinal fluid pathway in the normal and abnormal human embryos. Childs Brain. 1980;6(1):26-38.
Articles
Killer HE, Jaggi GP, Flammer J, Miller NR, Huber AR, Mironov A. Cerebrospinal fluid dynamics between the intracranial and the subarachnoid space of the optic nerve. Is it always bidirectional? Brain. 2007 Feb;130(Pt 2):514-20. Epub 2006 Nov 17. PMID: 17114796 [PubMed - indexed for MEDLINE]
Killer HE, Jaggi GP, Flammer J, Miller NR, Huber AR. The optic nerve: a new window into cerebrospinal fluid composition? Brain. 2006 Apr;129(Pt 4):1027-30.
Heep A, Bartmann P, Stoffel-Wagner B, Bos A, Hoving E, Brouwer O, Teelken A, Schaller C, Sival D. Cerebrospinal fluid obstruction and malabsorption in human neonatal hydrocephaly. Childs Nerv Syst. 2006 Oct;22(10):1249-55.
Patelska-Banaszewska M, Wozniak W. The subarachnoid space develops early in the human embryonic period. Folia Morphol (Warsz). 2005 Aug;64(3):212-6.
Dziegielewska KM, Ek J, Habgood MD, Saunders NR. Development of the choroid plexus. Microsc Res Tech. 2001 Jan 1;52(1):5-20.
Speake T, Whitwell C, Kajita H, Majid A, Brown PD. Mechanisms of CSF secretion by the choroid plexus. Microsc Res Tech. 2001 Jan 1;52(1):49-59.
Rickert CH, Paulus W. Tumors of the choroid plexus. Microsc Res Tech. 2001 Jan 1;52(1):104-11.
Guermazi A, De Kerviler E, Zagdanski AM, Frija J. Diagnostic imaging of choroid plexus disease. Clin Radiol. 2000 Jul;55(7):503-16.
Segal MB. The choroid plexuses and the barriers between the blood and the cerebrospinal fluid. Cell Mol Neurobiol. 2000 Apr;20(2):183-96.
Weisgerber C, Husmann M, Frosch M, Rheinheimer C, Peuckert W, Gorgen I, Bitter-Suermann D. Embryonic neural cell adhesion molecule in cerebrospinal fluid of younger children: age-dependent decrease during the first year. J Neurochem. 1990 Dec;55(6):2063-71.
O'Rahilly R, Muller F. Ventricular system and choroid plexuses of the human brain during the embryonic period proper. Am J Anat. 1990 Dec;189(4):285-302.
Osaka K, Handa H, Matsumoto S, Yasuda M Development of the cerebrospinal fluid pathway in the normal and abnormal human embryos. Childs Brain. 1980;6(1):26-38.
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