The Fluctuation of the Cerebrospinal Fluid

Movement of the Cerebro-Spinal Fluid (CSF) is a well-established phenomenon. CSF flows through the ventricles of the brain and within the spaces around the brain and spinal cord. Sutherland described this motion as fluctuant in nature.

  • Much of the research regarding the motion of CSF has already been cited in the previous section The Inherent Rhythmic Motion of the Brain and Spinal Cord.
  • DuBolay et al.1 summarized over a century of research, stating that the rise in CSF pressure, measured in parts of the brain and low back, is caused by the pulsatile nature of blood flow to the head.
  • O‘Connell3 also referred to a “CSF pump.”

The spinal dural membranes have a notable effect on the flow of CSF.

  • Levy et al.4 studied spinal CSF flow rates and brain pulsations in healthy patients and those with certain spinal conditions. They concluded that spinal cord pulsations are directly related to brain pulsations, stating “The origin of cord pulsations is compatible with a direct transfer of motion from brain pulsations.”

In 1902, Dr. AT Still said,

“The Cerebro-spinal Fluid was the highest known element in the human body,” and “this great river of life must be tapped and the withering fields irrigated at once or the harvest of health be forever lost.” He also stated that “the lymphatics… all drink from the waters of the brain.”

Dr. Sutherland emphasized the extravasation of CSF into the periphery as a central tenet of OCF. Until very recently, conventional neuroscience considered the CSF a closed system, confined to the brain and spinal chord. Recent research, however has demonstrated new pathways of formation, absorption and distribution of CSF… profoundly supporting the prescient statements of both Dr. Still and Dr. Sutherland.

  • Iliff et al. describe an anatomically distinct (“glymphatic”) clearing systemin the brain that serves a lymphatic-like function.
  • Also of considerable note are the July 2015 findings of Louveau, etal. Functional lymphatic vessels lining the dural sinuses, were newly discovered, and found to be capable of carrying both fluid and immune cells from the cerebrospinal fluid, and connecting to the deep cervical lymph nodes. This central nervous system lymphatic system calls for “a reassessment of basic assumptions in neuroimmunology and sheds new light on the aetiology of neuroinflammatory and neurodegenerative diseases associated with immune system dysfunction.”

Summary

Decades of research provide abundant evidence for the fluctuant activity of Cerebro-Spinal Fluid. Recent studies now demonstrate the extravasation of Cerebro-Spinal Fluid outside the confines of the central nervous system.

References

  1. DuBolay GH, O’Connell J, Currie J, et al. Further investigations on pulsatile movements in the cerebrospinal fluid pathways. Acta Radiol Diagnost 1971;13:496-523.
  2. Becher E. Untersuchen über die Dynamic der “Cerebospinalis.” Mitt Grenzgeb Med Chir. 1922;35:329.
  3. O’Connell JAE. Vascular factor in intracranial pressure and maintenance of cerebro-spinal fluid circulation. Brain. 1943;66:204-228.
  4. Levy LM, DiChiro GD, McCollough DC, et al. Fixed spinal cord: Diagnosis with MR imaging. Radiology 1988;169:773-778.
  5. Iliff JJ, et al; A Paravascular Pathway Facilitates CSF Flow Through the Brain Parenchyma and the Clearance of Interstitial Solutes, Including Amyloid β; Sci Transl Med 4, 147ra111 (2012); DOI: 10.1126/scitranslmed.3003748
  6. Louveau A, Smirnov I, Keyes TJ, Eccles JD, Rouhani SJ, Peske JD, Derecki NC, Castle D, Mandell JW, Lee KS, Harris TH, Kipnis J; Structural and functional features of central nervous system lymphatic vessels; Nature 523, 337–341 (16 July 2015) doi:10.1038/nature14432