Neural - Ventricular System Development - Revision history

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2020-04-16T01:12:29Z

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	==CSF Reabsorption==		==CSF Reabsorption==

	The main reabsorption (absorption) of CSF is thought to occur in {{arachnoid villi}} (arachnoid granulations, Pacchionian granulations), into the superior sagittal sinus, into the venous system. CSF in the subarachnoid space extends into the villi, which then project through the dura into the superior sagittal sinus.		The main reabsorption (absorption) of CSF is thought to occur in {{arachnoid villi}} (arachnoid granulations, Pacchionian granulations, Pacchionian body), into the superior sagittal sinus, into the venous system. CSF in the subarachnoid space extends into the villi, which then project through the dura into the superior sagittal sinus.

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			* '''Antonio Pacchioni''' (1665-1726) in ''Dissertatio Epistolaris de Glandulis Conglobatis Durae Meningis Humanae'' (1705) first described these arachnoid granulations.{{#pmid:8442786\|PMID8442786}}

	==Adult CSF Normal Values==		==Adult CSF Normal Values==

Z8600021 at 00:56, 16 April 2020

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	==CSF Reabsorption==		==CSF Reabsorption==

			The main reabsorption (absorption) of CSF is thought to occur in {{arachnoid villi}} (arachnoid granulations, Pacchionian granulations), into the superior sagittal sinus, into the venous system. CSF in the subarachnoid space extends into the villi, which then project through the dura into the superior sagittal sinus.

	~~Arachnoid Granulation (image: Gray's Anatomy)~~

	CSF ~~drainage (absorption or~~ reabsorption~~) into the venous system is through arachnoid granulations~~.		Recently, in the {{rabbit}} model, extra-cranial reabsorption of CSF has been identified with direct venous connections between the subarachnoid space and the perispinal veins.{{#pmid:22243405\|PMID22243405}} In addition, clusters of arachnoidal villi have been identified in the dorsal root of the spinal nerves and the absorptive surface areas of microvessels have been suggested to serve a putative role in reabsorption.

	~~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.~~

	==Adult CSF Normal Values==		==Adult CSF Normal Values==

Z8600021 at 00:44, 16 April 2020

2020-04-16T00:44:24Z

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	===Embryonic===		===Embryonic===

	Subarachnoid space, choroid plexus, and arachnoid villi studied in 60 normal human embryos.<ref name=Ref-OsakaMatsumotoYasuda1977>{{Ref-OsakaMatsumotoYasuda1977}}</ref>		Subarachnoid space, choroid plexus, and arachnoid villi studied in 60 normal human embryos.<ref name=Ref-OsakaMatsumotoYasuda1977>{{Ref-OsakaMatsumotoYasuda1977}}</ref> and other studies.{{#pmid:16228957\|PMID16228957}}{{#pmid:15478101\|PMID15478101}}

	* '''stage {{CS14}}''' - primitive subarachnoid space (future subarachnoid space) cavity formation within the meninx primitiva in the areas ventral to the middle brain vesicle. Primitive subarachnoid space precedes the appearance of the choroid plexus. The primitive subarachnoid space appears earlier in the region ventral to the rhombencephalon than in the region posterior to the fourth ventricle.		* '''stage {{CS14}}''' - primitive subarachnoid space (future subarachnoid space) cavity formation within the meninx primitiva in the areas ventral to the middle brain vesicle. Primitive subarachnoid space precedes the appearance of the choroid plexus. The primitive subarachnoid space appears earlier in the region ventral to the rhombencephalon than in the region posterior to the fourth ventricle.
			* Stage {{CS18}} - dura mater is formed and spaces surround the circumference of the spinal cord, which coalesce and contain many blood vessels.
	* '''stage {{CS20}}''' - primitive subarachnoid space almost completely surrounds the neural tube. Abnormal human embryo findings imply that the extra-ventricular spread of fluid of choroid plexus origin is not an essential factor for the development of the subarachnoid space.		* '''stage {{CS20}}''' - primitive subarachnoid space almost completely surrounds the neural tube. Abnormal human embryo findings imply that the extra-ventricular spread of fluid of choroid plexus origin is not an essential factor for the development of the subarachnoid space.
	* '''stage {{CS23}}''' - arachnoid villi do not appear even at the end of the embryonal stage. Absorption of the cerebrospinal fluid in an embryo is done by the way other than the arachnoid villi.		* '''stage {{CS23}}''' - arachnoid villi do not appear even at the end of the embryonal stage. Absorption of the cerebrospinal fluid in an embryo is done by the way other than the arachnoid villi.



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	Enzymes required for CSF production are Na+/K+ ATPase and carbonic anhydrase.		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){{#pmid:16228957\|PMID16228957}}~~

	==CSF Synthesis==		==CSF Synthesis==

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2020-04-16T00:28:43Z

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	* '''Cerebro-venous hypertension: a frequent cause of so-called "external hydrocephalus" in infants'''{{#pmid:30474714\|~~30474714~~}} "External hydrocephalus (eHC) is commonly defined as a subtype of infant "{{hydrocephalus}}" consisting of macrocepahly associated with enlarged subarachnoid space and no or mild ventriculomegaly. This status is thought to be related to impaired CSF absorption because of arachnoid villi immaturity. However, other factors like the venous system might be involved in the development of the clinical picture. Seventeen patients with the typical clinical feature of eHC were included. In 15, venous sinus abnormalities were found. There was a significant correlation between the volume of the widened cortical subarachnoid space (CSAS) and the number of venous sinus segments affected. Conversely, ventricular volume was not correlated. These results support the hypothesis that impaired venous outflow plays a major role in external hydrocephalus development. Raised venous pressure increases intracranial pressure accelerating head growth, resulting in an enlargement of the cortical subarachnoid space. Increased venous pressure increases the capillary bed pressure and brain turgor preventing ventricular space to enlarge forcing displacement of ventricular CSF to the subarachnoid space. As a result, ventriculomegaly is rarely found. The descriptive term "external hydrocephalus" implying a primary etiology within the CSF system is misleading and this work supports the notion that venous hypertension is the leading cause of the clinical picture."		* '''Cerebro-venous hypertension: a frequent cause of so-called "external hydrocephalus" in infants'''{{#pmid:30474714\|PMID30474714}} "External hydrocephalus (eHC) is commonly defined as a subtype of infant "{{hydrocephalus}}" consisting of macrocepahly associated with enlarged subarachnoid space and no or mild ventriculomegaly. This status is thought to be related to impaired CSF absorption because of arachnoid villi immaturity. However, other factors like the venous system might be involved in the development of the clinical picture. Seventeen patients with the typical clinical feature of eHC were included. In 15, venous sinus abnormalities were found. There was a significant correlation between the volume of the widened cortical subarachnoid space (CSAS) and the number of venous sinus segments affected. Conversely, ventricular volume was not correlated. These results support the hypothesis that impaired venous outflow plays a major role in external hydrocephalus development. Raised venous pressure increases intracranial pressure accelerating head growth, resulting in an enlargement of the cortical subarachnoid space. Increased venous pressure increases the capillary bed pressure and brain turgor preventing ventricular space to enlarge forcing displacement of ventricular CSF to the subarachnoid space. As a result, ventriculomegaly is rarely found. The descriptive term "external hydrocephalus" implying a primary etiology within the CSF system is misleading and this work supports the notion that venous hypertension is the leading cause of the clinical picture."

	* '''The {{Cerebrospinal fluid}} Inflammatory Response to Preterm Birth'''{{#pmid:30258368\|PMID30258368}} "{{preterm birth}} is the leading risk factor for perinatal white matter injury, which can lead to motor and neuropsychiatric impairment across the life course. There is an unmet clinical need for therapeutics. White matter injury is associated with an altered inflammatory response in the brain, primarily led by microglia, and subsequent hypomyelination. However, microglia can release both damaging and trophic factors in response to injury, and a comprehensive assessment of these factors in the preterm central nervous system (CNS) has not been carried out. Method: A custom antibody array was used to assess relative levels of 50 inflammation- and myelination-associated proteins in the {{cerebrospinal fluid}} (CSF) of preterm infants in comparison to term controls. Conclusion: Preterm CSF shows a distinct neuroinflammatory profile compared to term controls, suggestive of a complex neural environment with concurrent damaging and reparative signals. We propose that limitation of pro-inflammatory responses, which occur early after perinatal insult, may prevent expression of myelination-suppressive genes and support healthy white matter development." {{preterm birth}}		* '''The {{Cerebrospinal fluid}} Inflammatory Response to Preterm Birth'''{{#pmid:30258368\|PMID30258368}} "{{preterm birth}} is the leading risk factor for perinatal white matter injury, which can lead to motor and neuropsychiatric impairment across the life course. There is an unmet clinical need for therapeutics. White matter injury is associated with an altered inflammatory response in the brain, primarily led by microglia, and subsequent hypomyelination. However, microglia can release both damaging and trophic factors in response to injury, and a comprehensive assessment of these factors in the preterm central nervous system (CNS) has not been carried out. Method: A custom antibody array was used to assess relative levels of 50 inflammation- and myelination-associated proteins in the {{cerebrospinal fluid}} (CSF) of preterm infants in comparison to term controls. Conclusion: Preterm CSF shows a distinct neuroinflammatory profile compared to term controls, suggestive of a complex neural environment with concurrent damaging and reparative signals. We propose that limitation of pro-inflammatory responses, which occur early after perinatal insult, may prevent expression of myelination-suppressive genes and support healthy white matter development." {{preterm birth}}

Z8600021 at 00:28, 16 April 2020

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			* '''Cerebro-venous hypertension: a frequent cause of so-called "external hydrocephalus" in infants'''{{#pmid:30474714\|30474714}} "External hydrocephalus (eHC) is commonly defined as a subtype of infant "{{hydrocephalus}}" consisting of macrocepahly associated with enlarged subarachnoid space and no or mild ventriculomegaly. This status is thought to be related to impaired CSF absorption because of arachnoid villi immaturity. However, other factors like the venous system might be involved in the development of the clinical picture. Seventeen patients with the typical clinical feature of eHC were included. In 15, venous sinus abnormalities were found. There was a significant correlation between the volume of the widened cortical subarachnoid space (CSAS) and the number of venous sinus segments affected. Conversely, ventricular volume was not correlated. These results support the hypothesis that impaired venous outflow plays a major role in external hydrocephalus development. Raised venous pressure increases intracranial pressure accelerating head growth, resulting in an enlargement of the cortical subarachnoid space. Increased venous pressure increases the capillary bed pressure and brain turgor preventing ventricular space to enlarge forcing displacement of ventricular CSF to the subarachnoid space. As a result, ventriculomegaly is rarely found. The descriptive term "external hydrocephalus" implying a primary etiology within the CSF system is misleading and this work supports the notion that venous hypertension is the leading cause of the clinical picture."

	* '''The {{Cerebrospinal fluid}} Inflammatory Response to Preterm Birth'''{{#pmid:30258368\|PMID30258368}} "{{preterm birth}} is the leading risk factor for perinatal white matter injury, which can lead to motor and neuropsychiatric impairment across the life course. There is an unmet clinical need for therapeutics. White matter injury is associated with an altered inflammatory response in the brain, primarily led by microglia, and subsequent hypomyelination. However, microglia can release both damaging and trophic factors in response to injury, and a comprehensive assessment of these factors in the preterm central nervous system (CNS) has not been carried out. Method: A custom antibody array was used to assess relative levels of 50 inflammation- and myelination-associated proteins in the {{cerebrospinal fluid}} (CSF) of preterm infants in comparison to term controls. Conclusion: Preterm CSF shows a distinct neuroinflammatory profile compared to term controls, suggestive of a complex neural environment with concurrent damaging and reparative signals. We propose that limitation of pro-inflammatory responses, which occur early after perinatal insult, may prevent expression of myelination-suppressive genes and support healthy white matter development." {{preterm birth}}		* '''The {{Cerebrospinal fluid}} Inflammatory Response to Preterm Birth'''{{#pmid:30258368\|PMID30258368}} "{{preterm birth}} is the leading risk factor for perinatal white matter injury, which can lead to motor and neuropsychiatric impairment across the life course. There is an unmet clinical need for therapeutics. White matter injury is associated with an altered inflammatory response in the brain, primarily led by microglia, and subsequent hypomyelination. However, microglia can release both damaging and trophic factors in response to injury, and a comprehensive assessment of these factors in the preterm central nervous system (CNS) has not been carried out. Method: A custom antibody array was used to assess relative levels of 50 inflammation- and myelination-associated proteins in the {{cerebrospinal fluid}} (CSF) of preterm infants in comparison to term controls. Conclusion: Preterm CSF shows a distinct neuroinflammatory profile compared to term controls, suggestive of a complex neural environment with concurrent damaging and reparative signals. We propose that limitation of pro-inflammatory responses, which occur early after perinatal insult, may prevent expression of myelination-suppressive genes and support healthy white matter development." {{preterm birth}}

Z8600021 at 00:25, 16 April 2020

2020-04-16T00:25:34Z

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	===Reviews===		===Reviews===
			{{#pmid:22100360}}

	{{#pmid:19154733}}		{{#pmid:19154733}}

Z8600021 at 00:23, 16 April 2020

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	\| [[File:Mark_Hill.jpg\|90px\|left]] {{Most_Recent_Refs}}		\| [[File:Mark_Hill.jpg\|90px\|left]] {{Most_Recent_Refs}}

	Search term: [http://www.ncbi.nlm.nih.gov/pubmed/?term=Neural+Ventricular+System+Development ''Neural Ventricular System Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=Choroid+Plexus+Development ''Choroid Plexus Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=Cerebrospinal+fluid+Development ''Cerebrospinal fluid Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=lateral+ventricles+Development ''lateral ventricles Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=third+ventricle+Development ''third d+ventricle Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=cerebral+aqueduct+Development ''cerebral aqueduct Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=central+canal+Development ''central canal Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=hydrocephalus ''hydrocephalus''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=Subarachnoid+Space+Development ''Subarachnoid Space Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=arachnoid+villi+development arachnoid villi development]		Search term: [http://www.ncbi.nlm.nih.gov/pubmed/?term=Neural+Ventricular+System+Development ''Neural Ventricular System Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=Choroid+Plexus+Development ''Choroid Plexus Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=Cerebrospinal+fluid+Development ''Cerebrospinal fluid Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=lateral+ventricles+Development ''lateral ventricles Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=third+ventricle+Development ''third d+ventricle Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=cerebral+aqueduct+Development ''cerebral aqueduct Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=central+canal+Development ''central canal Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=hydrocephalus ''hydrocephalus''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=Subarachnoid+Space+Development ''Subarachnoid Space Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=arachnoid+villi+development ''arachnoid villi development'']

	\|}		\|}

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	\| [[File:Mark_Hill.jpg\|90px\|left]] {{Most_Recent_Refs}}		\| [[File:Mark_Hill.jpg\|90px\|left]] {{Most_Recent_Refs}}

	Search term: [http://www.ncbi.nlm.nih.gov/pubmed/?term=Neural+Ventricular+System+Development ''Neural Ventricular System Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=Choroid+Plexus+Development ''Choroid Plexus Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=Cerebrospinal+fluid+Development ''Cerebrospinal fluid Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=lateral+ventricles+Development ''lateral ventricles Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=third+ventricle+Development ''third d+ventricle Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=cerebral+aqueduct+Development ''cerebral aqueduct Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=central+canal+Development ''central canal Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=hydrocephalus ''hydrocephalus''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=Subarachnoid+Space+Development ''Subarachnoid Space Development'']		Search term: [http://www.ncbi.nlm.nih.gov/pubmed/?term=Neural+Ventricular+System+Development ''Neural Ventricular System Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=Choroid+Plexus+Development ''Choroid Plexus Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=Cerebrospinal+fluid+Development ''Cerebrospinal fluid Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=lateral+ventricles+Development ''lateral ventricles Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=third+ventricle+Development ''third d+ventricle Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=cerebral+aqueduct+Development ''cerebral aqueduct Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=central+canal+Development ''central canal Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=hydrocephalus ''hydrocephalus''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=Subarachnoid+Space+Development ''Subarachnoid Space Development''] \| [http://www.ncbi.nlm.nih.gov/pubmed/?term=arachnoid+villi+development arachnoid villi development]

	\|}		\|}
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	~~'''~~Embryonic ~~Development'''~~		===Embryonic===

	Subarachnoid space, choroid plexus, and arachnoid villi studied in 60 normal human embryos.<ref name=Ref-OsakaMatsumotoYasuda1977>{{Ref-OsakaMatsumotoYasuda1977}}</ref>		Subarachnoid space, choroid plexus, and arachnoid villi studied in 60 normal human embryos.<ref name=Ref-OsakaMatsumotoYasuda1977>{{Ref-OsakaMatsumotoYasuda1977}}</ref>

	* stage {{CS14}} - primitive subarachnoid space (future subarachnoid space) cavity formation within the meninx primitiva in the areas ventral to the middle brain vesicle. Primitive subarachnoid space precedes the appearance of the choroid plexus. The primitive subarachnoid space appears earlier in the region ventral to the rhombencephalon than in the region posterior to the fourth ventricle.		* '''stage {{CS14}}''' - primitive subarachnoid space (future subarachnoid space) cavity formation within the meninx primitiva in the areas ventral to the middle brain vesicle. Primitive subarachnoid space precedes the appearance of the choroid plexus. The primitive subarachnoid space appears earlier in the region ventral to the rhombencephalon than in the region posterior to the fourth ventricle.
	* stage {{CS20}} - primitive subarachnoid space almost completely surrounds the neural tube. Abnormal human embryo findings imply that the extra-ventricular spread of fluid of choroid plexus origin is not an essential factor for the development of the subarachnoid space.		* '''stage {{CS20}}''' - primitive subarachnoid space almost completely surrounds the neural tube. Abnormal human embryo findings imply that the extra-ventricular spread of fluid of choroid plexus origin is not an essential factor for the development of the subarachnoid space.
	* stage {{CS23}} - arachnoid villi do not appear even at the end of the embryonal stage. Absorption of the cerebrospinal fluid in an embryo ~~should be~~ done by the way other than the arachnoid villi.		* '''stage {{CS23}}''' - arachnoid villi do not appear even at the end of the embryonal stage. Absorption of the cerebrospinal fluid in an embryo is done by the way other than the arachnoid villi.

Z8600021 at 00:19, 16 April 2020

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	{{Embryonic Ventricular Timeline table}}		{{Embryonic Ventricular Timeline table}}


			'''Embryonic Development'''

			Subarachnoid space, choroid plexus, and arachnoid villi studied in 60 normal human embryos.<ref name=Ref-OsakaMatsumotoYasuda1977>{{Ref-OsakaMatsumotoYasuda1977}}</ref>

			* stage {{CS14}} - primitive subarachnoid space (future subarachnoid space) cavity formation within the meninx primitiva in the areas ventral to the middle brain vesicle. Primitive subarachnoid space precedes the appearance of the choroid plexus. The primitive subarachnoid space appears earlier in the region ventral to the rhombencephalon than in the region posterior to the fourth ventricle.
			* stage {{CS20}} - primitive subarachnoid space almost completely surrounds the neural tube. Abnormal human embryo findings imply that the extra-ventricular spread of fluid of choroid plexus origin is not an essential factor for the development of the subarachnoid space.
			* stage {{CS23}} - arachnoid villi do not appear even at the end of the embryonal stage. Absorption of the cerebrospinal fluid in an embryo should be done by the way other than the arachnoid villi.